Chapter 4121: INDUSTRIAL COMMISSION; BUREAU OF WORKERS' COMPENSATION

(1) "Place of employment" means every place,
whether indoors or out, or underground, and the premises appurtenant thereto,
where either temporarily or permanently any industry, trade, or business is
carried on, or where any process or operation, directly or indirectly related
to any industry, trade, or business, is carried on and where any person is
directly or indirectly employed by another for direct or indirect gain or
profit, but does not include any place where persons are employed in private
domestic service or agricultural pursuits which do not involve the use of
mechanical power.

(2) "Employment"
means any trade, occupation, or process of manufacture or any method of
carrying on such trade, occupation, or process of manufacture in which any
person may be engaged, except in such private domestic service or agricultural
pursuits as do not involve the use of mechanical power.

(3) "Employer" means every person, firm,
corporation, agent, manager, representative, or other person having control or
custody of any employment, place of employment, or employee.

(4) "Employee" means every person who may be
required or directed by any employer, in consideration of direct or indirect
gain or profit, to engage in any employment, or to go, or work, or be at any
time in any place of employment.

(5) "Frequenter" means every person, other
than an employee, who may go in or be in a place of employment under
circumstances which render the person other than a trespasser.

(6) "Deputy" means any person employed by the
industrial commission or the bureau of workers' compensation, designated as a
deputy by the commission or the administrator of workers' compensation, who
possesses special, technical, scientific, managerial, professional, or personal
abilities or qualities in matters within the jurisdiction of the commission or
the bureau, and who may be engaged in the performance of duties under the
direction of the commission or the bureau calling for the exercise of such
abilities or qualities.

(7) "Order"
means any decision, rule, regulation, direction, requirement, or standard, or
any other determination or decision that the bureau is empowered to and does
make.

(8) "General order" means an
order that applies generally throughout the state to all persons, employments,
or places of employment, or all persons, employments, or places of employment
of a class under the jurisdiction of the bureau. All other orders shall be
considered special orders.

(9)
"Local order" means any ordinance, order, rule, or determination of the
legislative authority of any municipal corporation, or any trustees, or board
or officers of any municipal corporation upon any matter over which the bureau
has jurisdiction.

(11) "Safe" or "safety," as applied to any
employment or a place of employment, means such freedom from danger to the
life, health, safety, or welfare of employees or frequenters as the nature of
the employment will reasonably permit, including requirements as to the hours
of labor with relation to the health and welfare of employees.

(12) "Employee organization" means any labor
or bona fide organization in which employees participate and that exists for
the purpose, in whole or in part, of dealing with employers concerning
grievances, labor disputes, wages, hours, terms, and other conditions of
employment.

(1) "Industrial
commission" means the chairperson of the three-member industrial commission
created pursuant to section
4121.02 of the Revised Code when
the context refers to the authority vested in the chairperson as the chief
executive officer of the three-member industrial commission pursuant to
divisions (A), (B), (C), and (D) of section
4121.03 of the Revised Code.

(2) "Industrial commission" means
the three-member industrial commission created pursuant to section
4121.02 of the Revised Code when
the context refers to the authority vested in the three-member industrial
commission pursuant to division (E) of section
4121.03 of the Revised Code.

(3) "Industrial commission" means
the industrial commission as a state agency when the context refers to the
authority vested in the industrial commission as a state agency.

(A) There is hereby created the industrial commission.
The commission shall consist of three members appointed by the governor, with
the advice and consent of the senate. One member shall be an individual who, on
account of the individual's previous vocation, employment, or affiliations, can
be classed as a representative of employers; one shall be an individual who, on
account of the individual's previous vocation, employment, or affiliations, can
be classed as a representative of employees; and one shall be an individual
who, on account of the individual's previous vocation, employment, or
affiliations, can be classed as a representative of the public. Each member
shall have six or more years of recognized expertise in the field of workers'
compensation, and at least one member shall be an attorney registered to
practice law in this state. No more than two members of the industrial
commission shall belong to or be affiliated with the same political
party.

(B) Within thirty days after the industrial commission
nominating council submits its list to the governor under division (D) of this
section, the governor shall make initial appointments to the commission. Of the
initial appointments, the member who is a representative of employees shall
serve a term ending on June 30, 1995; the member who is a representative of
employers shall serve a term ending on June 30, 1997; and the member who is a
representative of the public shall serve a term ending on June 30, 1999.
Thereafter, terms of office are for six years, beginning on the first day of
July and ending on the thirtieth day of June.

(C) Each member shall hold office from the date of the
member's confirmation by the senate, as provided in division (E) of this
section, until the end of the term for which the member was appointed, except
that if a member has not been appointed by the end of the term, the member
shall remain in office until the member's successor takes office, or until a
period of sixty days has elapsed, whichever occurs first. However, if a member
is appointed to fill a full term subsequent to an initial appointment, the term
of office is as provided in division (B) of this section. The governor shall
not appoint any person to more than two full six-year terms of office on the
commission. This restriction does not prevent the governor from appointing a
person to fill a vacancy caused by death, resignation, or removal of a
commission member, or from appointing that person twice to full terms on the
commission, or from appointing a person previously appointed to fill less than
a full term twice to full terms on the commission. Except for the public
member's tenure as chairperson of the self-insuring employer's evaluation
board, a member of the commission shall hold no other
office of trust or profit, engage in any
other occupation or business, or serve on any committee of any political party
and shall devote full time to the member's duties as a member of the
commission.

(D) In making appointments to the commission, the
governor shall select the members from the list of the names submitted by the
industrial commission nominating council pursuant to this division. Within
thirty days after October 20, 1993, the nominating
council shall submit to the governor for the initial appointments a list
containing three separate names for the employer, employee, and public members
to be filled. Within seven days of the submission of the initial list, the
governor shall either appoint individuals from the list or request the
nominating council to submit another list of three names for each member the
governor has not appointed from the original list, which list the nominating
council shall submit to the governor within seven days of the governor's
request. The governor then shall appoint, within seven days of the submission
of the second list, individuals from either list to fill each position for
which the governor has not made an appointment from the original list.
Thereafter, within sixty days of a vacancy occurring as a result of the
expiration of a term and within thirty days after other vacancies occurring on
the commission, the nominating council shall submit an initial list containing
three names for each vacancy. Within seven days of the submission of the
initial list, the governor shall either appoint individuals from the list or
request the nominating council to submit another list of three names for each
member the governor has not appointed from the original list, which list the
nominating council shall submit to the governor within fourteen days of the
governor's request. The governor then shall appoint, within seven days of the
submission of the second list, one of the individuals from either list to fill
the vacancy for which the governor has not made an appointment from the
original list. In order for a name of an individual to be submitted to the
governor under this division, the nominating council shall approve the
individual by an affirmative vote of not less than two-thirds of its
members.

(E) The governor shall notify the senate of the names
of the individuals for whom the governor is making the initial appointments to
the commission within thirty days after the submission of the names to the
governor by the industrial commission nominating council under division (D) of
this section. For appointments subsequent to the initial appointments under
this division, if the appointment is to fill a member's term which is to
expire, the governor shall notify the senate of the name of the individual to
be appointed to fill that position by no later than the first day of June of
the year that the term is to expire. For subsequent appointments to fill a
vacancy on the commission occurring as a result of the death, resignation, or
removal of the commission member, the governor shall notify the senate of the
name of the individual to be appointed to fill the remainder of that term
within thirty days after the submission of the names to the governor by the
nominating council under division (D) of this section. For all appointments,
the senate shall refer the matter to an appropriate standing committee for
consideration of the appointments, and the committee shall hold a public
hearing to consider the appointments. After conclusion of the public hearing,
the standing committee shall make its recommendations to the senate. The senate
shall not confirm any appointee if the individual does not meet the
qualifications of division (A) of this section or if the individual has not
been approved by the industrial commission nominating council as provided in
division (D) of this section. If the full senate fails to take a final vote on
an appointment within thirty days after the governor submits the names to the
senate under this division, the individual's appointment is deemed confirmed by
the senate and the individual shall take the office of commission member
subject to removal as provided in division (F) of this section.

(F) The governor may remove or suspend a member of the
commission pursuant to section 3.04 of the Revised Code. The governor shall
notify the senate of any decision to remove or suspend a commission member. The
senate shall refer the matter to an appropriate standing committee for
consideration and the committee shall hold a public hearing to consider the
matter. At the hearing, the governor or the governor's authorized
representative may present evidence and give testimony in support of the
decision. The commission member or the member's authorized representatives may
appear and present evidence and testimony. After conclusion of the public
hearing, the committee shall make its recommendation to the senate.

Upon receipt of a
recommendation from the standing committee, the senate shall vote on the issue
of whether to advise and consent to the removal or suspension of the member.
The senate shall vote on the matter within sixty legislative days from the date
the governor communicates the decision to remove or suspend the
member.

(G) The governor shall determine the compensation of
the members of the commission, based upon such facts as the governor considers
appropriate, provided that the salary of each member shall be no less than
seventy-five thousand dollars per year. In addition, each commission member
shall receive an annual salary increase based upon the average salary increases
of other state department directors for that year, not to exceed five per cent
per year.

(H) Before entering upon the duties of office, each
member shall take and subscribe to the constitutional oath of office and swear
and affirm that the member holds no position under any committee of a political
party, which oath or affirmation the member shall file in the office of the
governor. Each member shall give a bond in the sum of fifty thousand dollars,
which bond shall be approved by the governor and filed with the treasurer of
state. All employees or deputies of the commission who receive or disburse
state funds shall give a bond to the state in the amounts and surety approved
by the industrial commission.

The industrial commission operating fund is hereby created in
the state treasury. The fund shall consist of all moneys transferred to the
fund pursuant to division (C) of section
4123.342 of the Revised Code.
Revenues credited to the fund shall be used for those costs solely attributable
to the activities of the commission.

(A) The governor shall appoint from among the members
of the industrial commission the chairperson of the industrial commission. The
chairperson shall serve as chairperson at the pleasure of the governor. The
chairperson is the head of the commission and its chief executive
officer.

(B) The chairperson shall appoint, after consultation
with other commission members and obtaining the approval of at least one other
commission member, an executive director of the commission. The executive
director shall serve at the pleasure of the chairperson. The executive
director, under the direction of the chairperson, shall perform all of the
following duties:

(1)
Except as otherwise provided in this division, employ, promote, supervise,
remove, and establish the compensation of all employees as needed in connection
with the performance of the commission's duties under this chapter and Chapters
4123., 4127., and 4131. of the Revised Code and may assign to them their duties
to the extent necessary to achieve the most efficient performance of its
functions, and to that end may establish, change, or abolish positions, and
assign and reassign duties and responsibilities of every employee of the
commission. The civil service status of any person employed by the commission
prior to November 3, 1989, is not affected by this section. Personnel employed
by the bureau or the commission who are subject to Chapter 4117. of the Revised
Code shall retain all of their rights and benefits conferred pursuant to that
chapter as it presently exists or is hereafter amended and nothing in this
chapter or Chapter 4123. of the Revised Code shall be construed as eliminating
or interfering with Chapter 4117. of the Revised Code or the rights and
benefits conferred under that chapter to public employees or to any bargaining
unit.

(2) Hire
district and staff hearing officers after consultation with other commission
members and obtaining the approval of at least one other commission
member;

(3) Fire
staff and district hearing officers when the chairperson finds appropriate
after obtaining the approval of at least one other commission member;

(5)
To the maximum extent possible, use electronic data processing equipment for
the issuance of orders immediately following a hearing, scheduling of hearings
and medical examinations, tracking of claims, retrieval of information, and any
other matter within the commission's jurisdiction, and shall provide and input
information into the electronic data processing equipment as necessary to
effect the success of the claims tracking system established pursuant to
division (B)(14) of section
4121.121 of the Revised
Code;

(6) Exercise
all administrative and nonadjudicatory powers and duties conferred upon the
commission by Chapters 4121., 4123., 4127., and 4131. of the Revised
Code;

(D) The chairperson is responsible for all
administrative matters and may secure for the commission facilities, equipment,
and supplies necessary to house the commission, any employees, and files and
records under the commission's control and to discharge any duty imposed upon
the commission by law, the expense thereof to be audited and paid in the same
manner as other state expenses. For that purpose, the chairperson, separately
from the budget prepared by the administrator of workers' compensation, shall
prepare and submit to the office of budget and management a budget for each
biennium according to sections
101.532 and
107.03 of the Revised Code. The
budget submitted shall cover the costs of the commission and staff and district
hearing officers in the discharge of any duty imposed upon the chairperson, the
commission, and hearing officers by law.

(E) A majority of the commission constitutes a quorum
to transact business. No vacancy impairs the rights of the remaining members to
exercise all of the powers of the commission, so long as a majority remains.
Any investigation, inquiry, or hearing that the commission may hold or
undertake may be held or undertaken by or before any one member of the
commission, or before one of the deputies of the commission, except as
otherwise provided in this chapter and Chapters 4123., 4127., and 4131. of the
Revised Code. Every order made by a member, or by a deputy, when approved and
confirmed by a majority of the members, and so shown on its record of
proceedings, is the order of the commission. The commission may hold sessions
at any place within the state. The commission is responsible for all of the
following:

(1)
Establishing the overall adjudicatory policy and management of the commission
under this chapter and Chapters 4123., 4127., and 4131. of the Revised Code,
except for those administrative matters within the jurisdiction of the
chairperson, bureau of workers' compensation, and the administrator of workers'
compensation under those chapters;

(2)
Hearing appeals and reconsiderations under this chapter and Chapters 4123.,
4127., and 4131. of the Revised Code;

(3)
Engaging in rulemaking where required by this chapter or Chapter 4123., 4127.,
or 4131. of the Revised Code.

(A) There is
hereby created the industrial commission nominating council consisting of
five
employer representatives , four labor representatives,
one representative from the Ohio association for justice, and two members
of the public, each of a different political party, who
are appointed by the governor. The nominating council shall make
recommendations to the governor for the appointment of members to the
industrial commission as provided in section
4121.02 of the Revised Code.

(B) In making the appointments, the governor shall
select the members representing employees from a list of eight names submitted
by the Ohio federation of labor, the member
representing the Ohio association for justice from a list of two names
submitted by the Ohio association of justice, and the members
representing employers from a list of ten names
submitted jointly by the
Ohio industry organizations .
The governor shall appoint at least one member from each of the
Ohio industry organizations
. Of the
list submitted by the Ohio industry organizations
, two individuals
from each of the Ohio industry organizations
shall be
included in the list. Terms of office of employer and
employee representatives are for four years, each term ending on the same day
as the date of their original appointment. The Ohio federation of labor for a
vacancy of an employee representative on the council, and the Ohio industry
organizations, for a vacancy of an employer representative on the council,
shall submit to the governor a list containing two names for appointment and
the governor shall appoint an individual from the list to fill the vacancy
provided that the list submitted to fill an industry representative vacancy
shall contain the names of individuals who represent the organizations for
which a vacancy has occurred. One public member shall represent the interests
of small business . Public members shall serve for a term of two years,
each term ending on the same day as the date of their original appointment. The
governor shall fill a vacancy occurring on the nominating council for a public
member in the same manner as for the original appointment but only for the
unexpired part of the term. As used in this division, "small business" means
any manufacturing establishment employing five hundred or fewer employees or
any retail, or other service establishment employing one hundred or fewer
employees. The representative from the Ohio association
for justice shall serve for a term of four years, each term ending on the
twentieth day of October of the appropriate year. The governor shall fill a
vacancy occurring on the nominating council for the representative from the
Ohio association for justice in the same manner as the original
appointment. In the event that an appointment to the council does not
conform to this division, such organizations may challenge the appointment
pursuant to division (E) of this section, provided that the industry
organizations only may challenge the appointment of an industry representative,
and further provided that the labor organization only may challenge the
appointment of a labor representative.

(C)The nominating council annually
shall meet and elect such officers as it determines appropriate and shall meet
at such other times as it determines appropriate in order to make
recommendations to the governor for the appointment of industrial commission
members pursuant to section
4121.02 of the Revised Code.

(D) Members of the nominating council shall be paid
fifty dollars per day and their actual and necessary expenses while engaged in
the performance of their duties as members of the nominating council, which the
industrial commission shall pay from funds which the industrial commission uses
to pay its operating expenses.

(E)
An association generally recognized as representing the interests of labor or
industry may file, within fifteen days after the governor's appointment of a
member, a challenge in the common pleas court of Franklin county asserting that
a representative named to represent its interests is not representative of the
interests the appointee has been appointed to represent. An appointee whose
appointment has been challenged shall not receive any pay nor serve on the
nominating council until the court, acting without a jury and following the
expedited timetable provided for hearing on restraining orders in Civil Rule
65, makes a determination that the appointee is a true and qualified
representative of the group for which the appointee is selected and possesses
all of the qualifications.

A challenged appointee
may request the attorney general to represent the appointee in an action
brought under this division and the attorney general shall provide the
appointee with competent representation without charge.

(F) As
used in this section, "Ohio industry organizations" means all of the following
organizations:

The members of the industrial commission, the administrator of
workers' compensation, and employees and deputies of the commission and the
bureau of workers' compensation are entitled to receive from the state their
necessary and actual expenses while traveling on business of the commission or
the bureau, either within or without the state. The expenses shall be presented
in an account verified by the person who incurred the expense, approved by the
chairman of the commission for commission personnel and the administrator for
bureau personnel, and shall be audited and paid as other similar expenses are
audited and paid.

The industrial commission shall have an official seal for the
authentication of its orders and proceedings, upon which seal shall be engraved
"The Industrial Commission of Ohio," and such other design as the commission
prescribes. The courts in this state shall take judicial notice of such seal,
and in all cases copies of orders, proceedings, or records in the office of the
commission, certified by the executive director of the commission under its
seal, shall be equal to the original as evidence.

The industrial commission shall be in continuous session and
open for the transaction of business during all business hours of every day
excepting Sundays and legal holidays. The sessions of the commission shall be
open to the public and shall stand and be adjourned without further notice
thereof on its record. All of the proceedings of the commission shall be shown
on its record, which shall be a public record except as provided in section
4123.88 of the Revised Code, and
all voting shall be had by calling the name of each member of the industrial
commission by the executive director, and each member's vote shall be recorded
on the record of proceedings as cast. The commission shall keep a separate
record of its proceedings relative to claims coming before it for compensation
for injured and the dependents of killed employees, which record shall contain
its findings and the award in each such claim for compensation considered by
it, and in all such claims the reasons for the allowance or rejection thereof
shall be stated in said record.

Subject to any applicable sections of sections
4101.01 to
4101.16 and
4121.01 to
4121.29 of the Revised Code, the
bureau of workers' compensation may adopt its own rules of procedure and may
change the same in its discretion.

(A) There is hereby created the bureau of workers'
compensation board of directors consisting of eleven members to be appointed by
the governor with the advice and consent of the senate. One member shall be an
individual who, on account of the individual's previous vocation, employment,
or affiliations, can be classed as a representative of employees; two members
shall be individuals who, on account of their previous vocation, employment, or
affiliations, can be classed as representatives of employee organizations and
at least one of these two individuals shall be a member of the executive
committee of the largest statewide labor federation; three members shall be
individuals who, on account of their previous vocation, employment, or
affiliations, can be classed as representatives of employers, one of whom
represents self-insuring employers, one of whom is a state fund employer who
employs one hundred or more employees, and one of whom is a state fund employer
who employs less than one hundred employees; two members shall be individuals
who, on account of their vocation, employment, or affiliations, can be classed
as investment and securities experts who have direct experience in the
management, analysis, supervision, or investment of assets and are residents of
this state; one member who shall be a certified public accountant; one member
who shall be an actuary who is a member in good standing with the American
academy of actuaries or who is an associate or fellow with the
casualty actuarial society
; and one member shall
represent the public and also be an individual who, on account of the
individual's previous vocation, employment, or affiliations, cannot be classed
as either predominantly representative of employees or of employers. The
governor shall select the chairperson of the board who shall serve as
chairperson at the pleasure of the governor.

None of the members of
the board, within one year immediately preceding the member's appointment,
shall have been employed by the bureau of workers' compensation or by any
person, partnership, or corporation that has provided to the bureau services of
a financial or investment nature, including the management, analysis,
supervision, or investment of assets.

(B)
Of the initial appointments made to the board, the governor shall appoint the
member who represents employees, one member who represents employers, and the
member who represents the public to a term ending one year after June 11, 2007;
one member who represents employers, one member who represents employee
organizations, one member who is an investment and securities expert, and the
member who is a certified public accountant to a term ending two years after
June 11, 2007; and one member who represents employers, one member who
represents employee organizations, one member who is an investment and
securities expert, and the member who is an actuary to a term ending three
years after June 11, 2007. Thereafter, terms of office shall be for three
years, with each term ending on the same day of the same month as did the term
that it succeeds. Each member shall hold office from the date of the member's
appointment until the end of the term for which the member was appointed.

Members may be
reappointed. Any member appointed to fill a vacancy occurring prior to the
expiration date of the term for which the member's predecessor was appointed
shall hold office as a member for the remainder of that term. A member shall
continue in office subsequent to the expiration date of the member's term until
a successor takes office or until a period of sixty days has elapsed, whichever
occurs first.

(C) In making appointments to the board, the governor
shall select the members from the list of names submitted by the workers'
compensation board of directors nominating committee pursuant to this division.
The nominating committee shall submit to the governor a list containing four
separate names for each of the members on the board. Within fourteen days after
the submission of the list, the governor shall appoint individuals from the
list.

At least thirty days
prior to a vacancy occurring as a result of the expiration of a term and within
thirty days after other vacancies occurring on the board, the nominating
committee shall submit an initial list containing four names for each vacancy.
Within fourteen days after the submission of the initial list, the governor
either shall appoint individuals from that list or request the nominating
committee to submit another list of four names for each member the governor has
not appointed from the initial list, which list the nominating committee shall
submit to the governor within fourteen days after the governor's request. The
governor then shall appoint, within seven days after the submission of the
second list, one of the individuals from either list to fill the vacancy for
which the governor has not made an appointment from the initial list. If the
governor appoints an individual to fill a vacancy occurring as a result of the
expiration of a term, the individual appointed shall begin serving as a member
of the board when the term for which the individual's predecessor was appointed
expires or immediately upon appointment by the governor, whichever occurs
later. With respect to the filling of vacancies, the nominating committee shall
provide the governor with a list of four individuals who are, in the judgment
of the nominating committee, the most fully qualified to accede to membership
on the board.

In order for the name of
an individual to be submitted to the governor under this division, the
nominating committee shall approve the individual by an affirmative vote of a
majority of its members.

(D)
All members of the board shall receive their reasonable and necessary expenses
pursuant to section
126.31 of the Revised Code while
engaged in the performance of their duties as members and also shall receive an
annual salary not to exceed sixty thousand dollars in total, payable on the
following basis:

(1) Except as
provided in division (D)(2) of this section, a member shall receive two
thousand five hundred dollars during a month in which the member attends one or
more meetings of the board and shall receive no payment during a month in which
the member attends no meeting of the board.

(2) A
member may receive no more than thirty thousand dollars per year to compensate
the member for attending meetings of the board, regardless of the number of
meetings held by the board during a year or the number of meetings in excess of
twelve within a year that the member attends.

(3)
Except as provided in division (D)(4) of this section, if a member serves on
the workers' compensation audit committee, workers' compensation actuarial
committee, or the workers' compensation investment committee, the member shall
receive two thousand five hundred dollars during a month in which the member
attends one or more meetings of the committee on which the member serves and
shall receive no payment during any month in which the member attends no
meeting of that committee.

(4) A
member may receive no more than thirty thousand dollars per year to compensate
the member for attending meetings of any of the committees specified in
division (D)(3) of this section, regardless of the number of meetings held by a
committee during a year or the number of committees on which a member serves.

The chairperson of the
board shall set the meeting dates of the board as necessary to perform the
duties of the board under this chapter and Chapters 4123., 4125., 4127., 4131.,
and 4167. of the Revised Code. The board shall meet at least twelve times a
year. The administrator of workers' compensation shall provide professional and
clerical assistance to the board, as the board considers
appropriate.

(E)
Before entering upon the duties of office, each appointed member of the board
shall take an oath of office as required by sections
3.22 and
3.23 of the
Revised Code and file in the office of the secretary of state the bond required
under section
4121.127 of the Revised
Code.

(b) A
statement of the net assets available for the provision of compensation and
benefits under this chapter and Chapters 4123., 4127., and 4131. of the Revised
Code as of the last day of the fiscal year;

(c) A
statement of any changes that occurred in the net assets available, including
employer premiums and net investment income, for the provision of compensation
and benefits and payment of administrative expenses, between the first and last
day of the fiscal year immediately preceding the date of the report;

(d)
The following information for each of the six consecutive fiscal years
occurring previous to the report:

(i) A
schedule of the net assets available for compensation and benefits;

(iv)
Annual employer premiums allocated for the provision of compensation and
benefits.

(e) A
description of any significant changes that occurred during the six years for
which the board provided the information required under division (F)(3)(d) of
this section that affect the ability of the board to compare that information
from year to year.

(4)
Review all independent financial audits of the bureau. The administrator shall
provide access to records of the bureau to facilitate the review required under
this division.

(a) An
independent actuarial firm to assist the board in making recommendations to the
administrator regarding premium rates;

(b) An
outside investment counsel to assist the workers' compensation investment
committee in fulfilling its duties;

(c) An
independent fiduciary counsel to assist the board in the performance of its
duties.

(7) Approve the
investment policy developed by the workers' compensation investment committee
pursuant to section
4121.129 of the Revised Code if
the policy satisfies the requirements specified in section
4123.442 of the Revised
Code.

(8) Review and
publish the investment policy no less than annually and make copies available
to interested parties.

(9) Prohibit,
on a prospective basis, any specific investment it finds to be contrary to the
investment policy approved by the board.

(10)
Vote to open each investment class and allow the administrator to invest in an
investment class only if the board, by a majority vote, opens that
class;

(11) After
opening a class but prior to the administrator investing in that class, adopt
rules establishing due diligence standards for employees of the bureau to
follow when investing in that class and establish policies and procedures to
review and monitor the performance and value of each investment
class;

(12) Submit a
report annually on the performance and value of each investment class to the
governor, the president and minority leader of the senate,
and the speaker and minority leader of the house
of representatives.

(a)
Administrative rules the administrator submits to it pursuant to division
(B)(5) of section
4121.121 of the Revised Code for
the classification of occupations or industries, for premium rates and
contributions, for the amount to be credited to the surplus fund, for rules and
systems of rating, rate revisions, and merit rating;

(b)
The duties and authority conferred upon the administrator pursuant to section
4121.37 of the Revised
Code;

(c) Rules the
administrator adopts for the health partnership program and the qualified
health plan system, as provided in sections
4121.44,
4121.441, and
4121.442 of the Revised
Code;

(d) Rules the
administrator submits to it pursuant to Chapter 4167. of the Revised Code
regarding the public employment risk reduction program and the protection of
public health care workers from exposure incidents.

As used in this
division, "public health care worker" and "exposure incident" have the same
meanings as in section
4167.25 of the Revised
Code.

(14) Perform
all duties required under this chapter and Chapters 4123., 4125., 4127., 4131.,
and 4167. of the Revised Code;

(15)
Meet with the governor on an annual basis to discuss the administrator's
performance of the duties specified in this chapter and Chapters 4123., 4125.,
4127., 4131., and 4167. of the Revised Code;

(16)
Develop and participate in a bureau of workers' compensation board of directors
education program that consists of all of the following:

(2)
Create any committees in addition to the workers' compensation audit committee,
the workers' compensation actuarial committee, and the workers' compensation
investment committee that the board determines are necessary to assist the
board in performing its duties.

(H)
The office of a member of the board who is convicted of or pleads guilty to a
felony, a theft offense as defined in section
2913.01 of the Revised Code, or a
violation of section
102.02,
102.03,
102.04,
2921.02,
2921.11,
2921.13,
2921.31,
2921.41,
2921.42,
2921.43, or
2921.44 of the Revised Code shall
be deemed vacant. The vacancy shall be filled in the same manner as the
original appointment. A person who has pleaded guilty to or been convicted of
an offense of that nature is ineligible to be a member of the board. A member
who receives a bill of indictment for any of the offenses specified in this
section shall be automatically suspended from the board pending resolution of
the criminal matter.

(I) For the purposes of division (G)(1) of section
121.22 of the Revised Code, the
meeting between the governor and the board to review the administrator's
performance as required under division (F)(15) of this section shall be
considered a meeting regarding the employment of the administrator.

(A) There is hereby created the bureau of workers'
compensation, which shall be administered by the administrator of workers'
compensation. A person appointed to the position of administrator shall possess
significant management experience in effectively managing an organization or
organizations of substantial size and complexity. A person appointed to the
position of administrator also shall possess a minimum of five years of
experience in the field of workers' compensation insurance or in another
insurance industry, except as otherwise provided when the conditions specified
in division (C) of this section are satisfied. The governor shall appoint the
administrator as provided in section
121.03 of the Revised Code, and
the administrator shall serve at the pleasure of the governor. The governor
shall fix the administrator's salary on the basis of the administrator's
experience and the administrator's responsibilities and duties under this
chapter and Chapters 4123., 4125., 4127., 4131., and 4167. of the Revised Code.
The governor shall not appoint to the position of administrator any person who
has, or whose spouse has, given a contribution to the campaign committee of the
governor in an amount greater than one thousand dollars during the two-year
period immediately preceding the date of the appointment of the administrator.

The administrator shall
hold no other public office and shall devote full time to the duties of
administrator. Before entering upon the duties of the office, the administrator
shall take an oath of office as required by sections
3.22 and
3.23 of the Revised Code, and
shall file in the office of the secretary of state, a bond signed by the
administrator and by surety approved by the governor, for the sum of fifty
thousand dollars payable to the state, conditioned upon the faithful
performance of the administrator's duties.

(B) The
administrator is responsible for the management of the bureau and for the
discharge of all administrative duties imposed upon the administrator in this
chapter and Chapters 4123., 4125., 4127., 4131., and 4167. of the Revised Code,
and in the discharge thereof shall do all of the following:

(1)
Perform all acts and exercise all authorities and powers, discretionary and
otherwise that are required of or vested in the bureau or any of its employees
in this chapter and Chapters 4123., 4125., 4127., 4131., and 4167. of the
Revised Code, except the acts and the exercise of authority and power that is
required of and vested in the bureau of workers' compensation board of
directors or the industrial commission pursuant to those chapters. The
treasurer of state shall honor all warrants signed by the administrator, or by
one or more of the administrator's employees, authorized by the administrator
in writing, or bearing the facsimile signature of the administrator or such
employee under sections
4123.42 and
4123.44 of the Revised
Code.

(2) Employ,
direct, and supervise all employees required in connection with the performance
of the duties assigned to the bureau by this chapter and Chapters 4123., 4125.,
4127., 4131., and 4167. of the Revised Code, including an actuary, and may
establish job classification plans and compensation for all employees of the
bureau provided that this grant of authority shall not be construed as
affecting any employee for whom the state employment relations board has
established an appropriate bargaining unit under section
4117.06 of the Revised Code. All
positions of employment in the bureau are in the classified civil service
except those employees the administrator may appoint to serve at the
administrator's pleasure in the unclassified civil service pursuant to section
124.11 of the Revised Code. The
administrator shall fix the salaries of employees the administrator appoints to
serve at the administrator's pleasure, including the chief operating officer,
staff physicians, and other senior management personnel of the bureau and shall
establish the compensation of staff attorneys of the bureau's legal section and
their immediate supervisors, and take whatever steps are necessary to provide
adequate compensation for other staff attorneys.

The administrator may
appoint a person who holds a certified position in the classified service
within the bureau to a position in the unclassified service within the bureau.
A person appointed pursuant to this division to a position in the unclassified
service shall retain the right to resume the position and status held by the
person in the classified service immediately prior to the person's appointment
in the unclassified service, regardless of the number of positions the person
held in the unclassified service. An employee's right to resume a position in
the classified service may only be exercised when the administrator demotes the
employee to a pay range lower than the employee's current pay range or revokes
the employee's appointment to the unclassified service. An employee who holds a
position in the classified service and who is appointed to a position in the
unclassified service on or after January 1, 2016, shall have the right to
resume a position in the classified service under this division only within
five years after the effective date of the employee's appointment in the
unclassified service. An employee forfeits the right to resume a position in
the classified service when the employee is removed from the position in the
unclassified service due to incompetence, inefficiency, dishonesty,
drunkenness, immoral conduct, insubordination, discourteous treatment of the
public, neglect of duty, violation of this chapter or Chapter 124., 4123.,
4125., 4127., 4131., or 4167. of the Revised Code, violation of the rules of
the director of administrative services or the administrator, any other failure
of good behavior, any other acts of misfeasance, malfeasance, or nonfeasance in
office, or conviction of a felony while employed in the
civil service. An employee also forfeits the right to resume a position
in the classified service upon transfer to a different agency.

Reinstatement to a
position in the classified service shall be to a position substantially equal
to that position in the classified service held previously, as certified by the
department of administrative services. If the position the person previously
held in the classified service has been placed in the unclassified service or
is otherwise unavailable, the person shall be appointed to a position in the
classified service within the bureau that the director of administrative
services certifies is comparable in compensation to the position the person
previously held in the classified service. Service in the position in the
unclassified service shall be counted as service in the position in the
classified service held by the person immediately prior to the person's
appointment in the unclassified service. When a person is reinstated to a
position in the classified service as provided in this division, the person is
entitled to all rights, status, and benefits accruing to the position during
the person's time of service in the position in the unclassified
service.

(3) Reorganize
the work of the bureau, its sections, departments, and offices to the extent
necessary to achieve the most efficient performance of its functions and to
that end may establish, change, or abolish positions and assign and reassign
duties and responsibilities of every employee of the bureau. All persons
employed by the commission in positions that, after November 3, 1989, are
supervised and directed by the administrator under this section are transferred
to the bureau in their respective classifications but subject to reassignment
and reclassification of position and compensation as the administrator
determines to be in the interest of efficient administration. The civil service
status of any person employed by the commission is not affected by this
section. Personnel employed by the bureau or the commission who are subject to
Chapter 4117. of the Revised Code shall retain all of their rights and benefits
conferred pursuant to that chapter as it presently exists or is hereafter
amended and nothing in this chapter or Chapter 4123. of the Revised Code shall
be construed as eliminating or interfering with Chapter 4117. of the Revised
Code or the rights and benefits conferred under that chapter to public
employees or to any bargaining unit.

(4)
Provide offices, equipment, supplies, and other facilities for the
bureau.

(5) Prepare and
submit to the board information the administrator considers pertinent or the
board requires, together with the administrator's recommendations, in the form
of administrative rules, for the advice and consent of the board, for
classifications of occupations or industries, for premium rates and
contributions, for the amount to be credited to the surplus fund, for rules and
systems of rating, rate revisions, and merit rating. The administrator shall
obtain, prepare, and submit any other information the board requires for the
prompt and efficient discharge of its duties.

(6) Keep
the accounts required by division (A) of section
4123.34 of the Revised Code and
all other accounts and records necessary to the collection, administration, and
distribution of the workers' compensation funds and shall obtain the
statistical and other information required by section
4123.19 of the Revised
Code.

(7) Exercise the
investment powers vested in the administrator by section
4123.44 of the Revised Code in
accordance with the investment policy approved by the board pursuant to section
4121.12 of the Revised Code and
in consultation with the chief investment officer of the bureau of workers'
compensation. The administrator shall not engage in any prohibited investment
activity specified by the board pursuant to division (F)(9) of section
4121.12 of the Revised Code and
shall not invest in any type of investment specified in divisions (B)(1) to
(10) of section 4123.442 of the Revised Code.
All business shall be transacted, all funds invested, all warrants for money
drawn and payments made, and all cash and securities and other property held,
in the name of the bureau, or in the name of its nominee, provided that
nominees are authorized by the administrator solely for the purpose of
facilitating the transfer of securities, and restricted to the administrator
and designated employees.

(8) In
accordance with Chapter 125. of the Revised Code, purchase supplies, materials,
equipment, and services.

(9) Prepare and
submit to the board an annual budget for internal operating purposes for the
board's approval. The administrator also shall, separately from the budget the
industrial commission submits, prepare and submit to the director of budget and
management a budget for each biennium. The budgets submitted to the board and
the director shall include estimates of the costs and necessary expenditures of
the bureau in the discharge of any duty imposed by law.

(10) As
promptly as possible in the course of efficient administration, decentralize
and relocate such of the personnel and activities of the bureau as is
appropriate to the end that the receipt, investigation, determination, and
payment of claims may be undertaken at or near the place of injury or the
residence of the claimant and for that purpose establish regional offices, in
such places as the administrator considers proper, capable of discharging as
many of the functions of the bureau as is practicable so as to promote prompt
and efficient administration in the processing of claims. All active and
inactive lost-time claims files shall be held at the service office responsible
for the claim. A claimant, at the claimant's request, shall be provided with
information by telephone as to the location of the file pertaining to the
claimant's claim. The administrator shall ensure that all service office
employees report directly to the director for their service office.

(11)
Provide a written binder on new coverage where the administrator considers it
to be in the best interest of the risk. The administrator, or any other person
authorized by the administrator, shall grant the binder upon submission of a
request for coverage by the employer. A binder is effective for a period of
thirty days from date of issuance and is nonrenewable. Payroll reports and
premium charges shall coincide with the effective date of the binder.

(12) Set
standards for the reasonable and maximum handling time of claims payment
functions, ensure, by rules, the impartial and prompt treatment of all claims
and employer risk accounts, and establish a secure, accurate method of time
stamping all incoming mail and documents hand delivered to bureau
employees.

(13) Ensure that
all employees of the bureau follow the orders and rules of the commission as
such orders and rules relate to the commission's overall adjudicatory
policy-making and management duties under this chapter and Chapters 4123.,
4127., and 4131. of the Revised Code.

(14)
Manage and operate a data processing system with a common data base for the use
of both the bureau and the commission and, in consultation with the commission,
using electronic data processing equipment, shall develop a claims tracking
system that is sufficient to monitor the status of a claim at any time and that
lists appeals that have been filed and orders or determinations that have been
issued pursuant to section
4123.511 or
4123.512 of the Revised Code,
including the dates of such filings and issuances.

(15)
Establish and maintain a medical section within the bureau. The medical section
shall do all of the following:

(a) Assist the
administrator in establishing standard medical fees, approving medical
procedures, and determining eligibility and reasonableness of the compensation
payments for medical, hospital, and nursing services, and in establishing
guidelines for payment policies which recognize usual, customary, and
reasonable methods of payment for covered services;

(b)
Provide a resource to respond to questions from claims examiners for employees
of the bureau;

(d) Implement a
program to utilize, to the maximum extent possible, electronic data processing
equipment for storage of information to facilitate authorizations of
compensation payments for medical, hospital, drug, and nursing
services;

(16)
Appoint, as the administrator determines necessary, panels to review and advise
the administrator on disputes arising over a determination that a health care
service or supply provided to a claimant is not covered under this chapter or
Chapter 4123., 4127., or 4131. of the Revised Code or is medically unnecessary.
If an individual health care provider is involved in the dispute, the panel
shall consist of individuals licensed pursuant to the same section of the
Revised Code as such health care provider.

(17)
Pursuant to section 4123.65 of the Revised Code,
approve applications for the final settlement of claims for compensation or
benefits under this chapter and Chapters 4123., 4127., and 4131. of the Revised
Code as the administrator determines appropriate, except in regard to the
applications of self-insuring employers and their employees.

(18)
Comply with section 3517.13 of the Revised Code, and
except in regard to contracts entered into pursuant to the authority contained
in section 4121.44 of the Revised Code,
comply with the competitive bidding procedures set forth in the Revised Code
for all contracts into which the administrator enters provided that those
contracts fall within the type of contracts and dollar amounts specified in the
Revised Code for competitive bidding and further provided that those contracts
are not otherwise specifically exempt from the competitive bidding procedures
contained in the Revised Code.

(19)
Adopt, with the advice and consent of the board, rules for the operation of the
bureau.

(20) Prepare and
submit to the board information the administrator considers pertinent or the
board requires, together with the administrator's recommendations, in the form
of administrative rules, for the advice and consent of the board, for the
health partnership program and the qualified health plan system, as provided in
sections 4121.44,
4121.441, and
4121.442 of the Revised
Code.

(C) The administrator, with the advice and consent of
the senate, shall appoint a chief operating officer who has a minimum of five
years of experience in the field of workers' compensation insurance or in
another similar insurance industry if the administrator does not possess such
experience. The chief operating officer shall not commence the chief operating
officer's duties until after the senate consents to the chief operating
officer's appointment. The chief operating officer shall serve in the
unclassified civil service of the state.

(A) The
administrator of workers' compensation, for employees of the bureau of workers'
compensation, and the industrial commission, for employees of the commission
may discipline, suspend, demote or discharge any employee for misfeasance,
malfeasance, or nonfeasance. In the case of any deputy administrator, or of any
employee assigned to the investigation or determination of claims, and finding
of the administrator or the commission that such person is not efficient,
impartial, or judicious, if supported by any evidence and not promoted by
personal, political, racial, or religious discrimination shall be accepted as a
fact justifying the action taken by the administrator or commission.

(B) The administrator and the commission
shall jointly adopt, in the form of a rule, a code of ethics for all employees
of the bureau and the commission and post copies of the rule in a conspicuous
place in every bureau and commission office.

(C) The administrator and the commission shall jointly
adopt rules setting forth procedures designed to eliminate outside influence on
bureau and commission employees, produce an impartial workers' compensation
claims handling process, and avoid favoritism in the claims handling process.
Failure to adopt and enforce these rules constitutes grounds for removal of the
administrator and the members of the commission.

(A) There is hereby created the workers' compensation
board of directors nominating committee consisting of the following:

(1) Three
individuals who are members of affiliated employee organizations of the Ohio
chapter of the American federation of labor-congress of industrial
organizations, who are selected by the Ohio chapter of the American federation
of labor-congress of industrial organizations and who, on account of their
previous vocation, employment, or affiliations, can be classed as
representative of employees who are members of an employee organization. Terms
of office shall be for one year, with each term ending on the same day of the
same month as did the term that it succeeds.

(2) Two
individuals who, on account of their previous vocation, employment, or
affiliations, can be classed as representative of employees, one of whom shall
be an injured worker with a valid, open, and active workers' compensation claim
and at least one of these two representatives also shall represent employees
who are not members of an employee organization. The president of the senate
and the speaker of the house of representatives each shall appoint annually one
of these members. The member who is an injured worker shall serve for a full
term even if the member's workers' compensation claim is invalidated, closed,
or inactivated during the member's term.

(3) The
chief executive officer, or the equivalent of the chief executive officer, of
the Ohio chamber of commerce, the Ohio manufacturers' association, the Ohio
self-insurers' association, the Ohio council of retail merchants, the national
federation of independent business, and the Ohio farm bureau;

(5) The
president of the Ohio township association and the president of the Ohio county
commissioners association, orif any of the following circumstances apply:

(a) In the
event of a vacancy in either
presidency, a designee appointed by the governing body authorized to appoint
the president. A designee so appointed shall serve on the nominating committee
only until the vacancy in the presidency is filled.

(b) In the event
that the president of the Ohio township association is unavailable, a designee
selected by the president;

(c) In the event
that the president of the Ohio county commissioners association is unavailable,
a designee selected by the president.

(B) Each member appointed under divisions (A)(1) and
(2) of this section shall hold office from the date of the member's appointment
until the end of the term for which the member was appointed. Such members may
be reappointed. Vacancies shall be filled in the manner provided for original
appointments. Any such member appointed to fill a vacancy occurring prior to
the expiration date of the term for which the member's predecessor was
appointed shall hold office as a member for the remainder of that term. Such a
member shall continue in office subsequent to the expiration date of the
member's term until the member's successor takes office or until a period of
sixty days has elapsed, whichever occurs first.

(C) The nominating committee shall meet at the request
of the governor or as the nominating committee determines appropriate in order
to make recommendations to the governor for the appointment of members of the
bureau of workers' compensation board of directors under section
4121.12 of the Revised
Code.

(D) The director of development shall serve as
chairperson of the nominating committee and have no voting rights on matters
coming before the nominating committee, except that the director may vote in
the event of a tie vote of the nominating committee. Annually, the nominating
committee shall select a secretary from among its members. The nominating
committee may adopt by-laws governing its proceedings.

(E) Members of the nominating committee shall be paid
their reasonable and necessary expenses pursuant to section
126.31 of the Revised Code while
engaged in the performance of their duties as members of the nominating
committee.

(1) Review
and evaluate possible appointees for the board. In reviewing and evaluating
possible appointees for the board, the nominating committee may accept comments
from, cooperate with, and request information from any person.

(2) Make
recommendations to the governor for the appointment of members to the board as
provided in division (C) of section
4121.12 of the Revised
Code.

(G) The nominating committee may make recommendations
to the general assembly concerning changes in legislation that will assist the
nominating committee in the performance of its duties.

(A) The bureau of workers' compensation board of
directors, based upon recommendations of the workers' compensation actuarial
committee, may contract with one or more outside actuarial firms and other
professional persons, as the board determines necessary, to assist the board in
measuring the performance of Ohio's workers' compensation system and in
comparing Ohio's workers' compensation system to other state and private
workers' compensation systems. The board, actuarial firm or firms, and
professional persons shall make such measurements and comparisons using
accepted insurance industry standards, including, but not limited to, standards
promulgated by the National Council on Compensation Insurance.

(B) The
board may contract with one or more outside firms to conduct management and
financial audits of the workers' compensation system, including audits of the
reserve fund belonging to the state insurance fund, and to establish objective
quality management principles and methods by which to review the performance of
the workers' compensation system.

(1)
Contract to have prepared annually by or under the supervision of an actuary a
report that meets the requirements specified under division (E) of this section
and that consists of an actuarial valuation of the assets, liabilities, and
funding requirements of the state insurance fund and all other funds specified
in this chapter and Chapters 4123., 4127., and 4131. of the Revised
Code;

(2) Require that
the actuary or person supervised by an actuary referred to in division (C)(1)
of this section complete the valuation in accordance with the actuarial
standards of practice promulgated by the actuarial standards board of the
American academy of actuaries;

(3)
Submit the report referred to in division (C)(1) of this section to
the
standing committees of the house of representatives and the senate with primary
responsibility for workers' compensation legislation on or before the first day
of November following the year for which the valuation was made;

(4) Have
an actuary or a person who provides actuarial services under the supervision of
an actuary, at such time as the board determines, and at least once during the
five-year period that commences on September 10, 2007, and once within each
five-year period thereafter, conduct an actuarial investigation of the
experience of employers, the mortality, service, and injury rate of employees,
and the payment of temporary total disability, permanent partial disability,
and permanent total disability under sections
4123.56 to
4123.58 of the Revised Code to
update the actuarial assumptions used in the report required by division (C)(1)
of this section;

(5) Submit the
report required under division (F) of this section to
the standing committees
of the house of representatives and the senate with primary responsibility for
workers' compensation legislation not later than the first day of November
following the fifth year of the period that the report covers;

(6) Have
prepared by or under the supervision of an actuary an actuarial analysis of any
introduced legislation expected to have a measurable financial impact on the
workers' compensation system;

(7)
Submit the report required under division (G) of this section to the
legislative service commissionand the standing committees of the house of
representatives and the senate with primary responsibility for workers'
compensation legislation
not later than sixty days after the date of introduction of the
legislation.

(D) The administrator of workers' compensation and the
industrial commission shall compile information and provide access to records
of the bureau and the industrial commission to the board to the extent
necessary for fulfillment of both of the following requirements:

(1)
Conduct of the measurements and comparisons described in division (A) of this
section;

(2) Conduct of
the management and financial audits and establishment of the principles and
methods described in division (B) of this section.

(E) The
firm or person with whom the board contracts pursuant to division (C)(1) of
this section shall prepare a report of the valuation and submit the report to
the board. The firm or person shall include all of the following information in
the report that is required under division (C)(1) of this section:

(2) A
description of the actuarial assumptionsand actuarial cost
method used
in the valuation;

(3) A schedule showing the effect of any
changes in the compensation and benefit provisions, actuarial assumptions, or
cost methods since the previous annual actuarial valuation report was submitted
to the board.

(F) The actuary
or person whom the board designates to conduct an actuarial investigation under
division (C)(4) of this section shall prepare a report of the actuarial
investigation and shall submit the report to the board. The actuary or person
shall prepare the report and make any recommended changes in actuarial
assumptions in accordance with the actuarial standards of practice promulgated
by the actuarial standards board of the American academy of actuaries. The
actuary or person shall include all of the following information in the report:

(1) A
summary of relevant decrement and economic assumption experience;

(2)
Recommended changes in actuarial assumptions to be used in subsequent actuarial
valuations required by division (C)(1) of this section;

(3) A
measurement of the financial effect of the recommended changes in actuarial
assumptions.

(G) The actuary or person whom the board designates to
conduct the actuarial analysis under division (C)(6) of this section shall
prepare a report of the actuarial analysis and shall submit that report to the
board. The actuary or person shall complete the analysis in accordance with the
actuarial standards of practice promulgated by the actuarial standards board of
the American academy of actuaries. The actuary or person shall include all of
the following information in the report:

(2) A
description of or reference to the actuarial assumptions and actuarial cost
method used in the report;

(3) A
description of the participant group or groups included in the
report;

(4) A statement
of the financial impact of the legislation, including the resulting increase,
if any, in employer premiums, in actuarial accrued liabilities, and, if an
increase in actuarial accrued liabilities is predicted, the per cent of premium
increase that would be required to amortize the increase in those liabilities
as a level per cent of employer premiums over a period not to exceed thirty
years.

(5) A statement
of whether the employer premiums paid to the bureau of workers' compensation
after the proposed change is enacted are expected to be sufficient to satisfy
the funding objectives established by the board.

(H) The
board may, at any time, request an actuary to make any studies or actuarial
valuations to determine the adequacy of the premium rates established by the
administrator in accordance with sections
4123.29 and
4123.34 of the Revised Code, and
may adjust those rates as recommended by the actuary.

(I) The
board shall have an independent auditor, at least once every ten years, conduct
a fiduciary performance audit of the investment program of the bureau of
workers' compensation. That audit shall include an audit of the investment
policies approved by the board and investment procedures of the bureau. The
board shall submit a copy of that audit to the auditor of state.

(J) The
administrator, with the advice and consent of the board, shall employ an
internal auditor who shall report findings directly to the board, workers'
compensation audit committee, and administrator, except that the internal
auditor shall not report findings directly to the administrator when those
findings involve malfeasance, misfeasance, or nonfeasance on the part of the
administrator. The board and the workers' compensation audit committee may
request and review internal audits conducted by the internal auditor.

(K) The
administrator shall pay the expenses incurred by the board to effectively
fulfill its duties and exercise its powers under this section as the
administrator pays other operating expenses of the bureau.

Except as provided in this chapter, no member of the bureau of
workers' compensation board of directors or employee of the bureau of workers'
compensation shall have any direct or indirect interest in the gains or profits
of any investment made by the administrator of workers' compensation or shall
receive directly or indirectly any pay or emolument for the member's or
employee's services. No member or person connected with the bureau directly or
indirectly, for self or as an agent or partner of others, shall borrow any of
its funds or deposits or in any manner use the funds or deposits except to make
current and necessary payments that are authorized by the administrator. No
member of the board or employee of the bureau shall become an indorser or
surety or become in any manner an obligor for moneys loaned by or borrowed from
the bureau.

The administrator shall make no investments through or
purchases from, or otherwise do any business with, any individual who is, or
any partnership, association, or corporation that is owned or controlled by, a
person who within the preceding three years was employed by the bureau, a board
member of, or an officer of the board, or a person who within the preceding
three years was employed by or was an officer holding a fiduciary,
administrative, supervisory, or trust position, or any other position in which
such person would be involved, on behalf of the person's employer, in decisions
or recommendations affecting the investment policy of the bureau, and in which
such person would benefit by any monetary gain.

(A) Except as
provided in division (B) of this section, a fiduciary shall not cause the
bureau of workers' compensation to engage in a transaction, if the fiduciary
knows or should know that such transaction constitutes any of the following,
whether directly or indirectly:

(1) The sale,
exchange, or leasing of any property between the bureau and a party in
interest;

(2) Lending of money or
other extension of credit between the bureau and a party in interest;

(3) Furnishing of goods, services,
or facilities between the bureau and a party in interest;

(4) Transfer to, or use by or for the benefit
of a party in interest, of any assets of the bureau;

(5) Acquisition, on behalf of the bureau, of
any employer security or employer real property.

(B) Nothing in this section shall prohibit any
transaction between the bureau and any fiduciary or party in interest if both
of the following occur:

(1) All the terms and
conditions of the transaction are comparable to the terms and conditions that
might reasonably be expected in a similar transaction between similar parties
who are not parties in interest.

(2) The transaction is consistent with
fiduciary duties under this chapter and Chapters 4123., 4127., and 4131. of the
Revised Code.

(1) Deal with the assets of the bureau in the
fiduciary's own interest or for the fiduciary's own account;

(2) In the fiduciary's individual capacity or
in any other capacity, act in any transaction involving the bureau on behalf of
a party, or represent a party, whose interests are adverse to the interests of
the bureau or to the injured employees served by the bureau;

(3) Receive any consideration for the
fiduciary's own personal account from any party dealing with the bureau in
connection with a transaction involving the assets of the bureau.

(D) In addition to any
liability that a fiduciary may have under any other provision, a fiduciary,
with respect to bureau, shall be liable for a breach of fiduciary
responsibility in any the following circumstances:

(1) If the fiduciary knowingly participates
in or knowingly undertakes to conceal an act or omission of another fiduciary,
knowing such act or omission is a breach;

(2) If, by the fiduciary's failure to comply
with this chapter or Chapter 4123., 4127., or 4131. of the Revised Code, the
fiduciary has enabled another fiduciary to commit a breach;

(3) If the fiduciary has knowledge of a
breach by another fiduciary of that fiduciary's duties under this chapter and
Chapters 4123., 4127., and 4131. of the Revised Code, unless the fiduciary
makes reasonable efforts under the circumstances to remedy the breach.

(E) Every fiduciary of
the bureau shall be bonded or insured for an amount of not less than one
million dollars for loss by reason of acts of fraud or dishonesty.

(F) As used in this section, "fiduciary"
means a person who does any of the following:

(1) Exercises discretionary authority or
control with respect to the management of the bureau or with respect to the
management or disposition of its assets;

(2) Renders investment advice for a fee,
directly or indirectly, with respect to money or property of the bureau;

(3) Has discretionary authority or
responsibility in the administration of the bureau.

(A) There is hereby created the workers' compensation
audit committee consisting of at least three members. One member shall be the
member of the bureau of workers' compensation board of directors who is a
certified public accountant. The board, by majority vote, shall appoint two
additional members of the board to serve on the audit committee and may appoint
additional members who are not board members, as the board determines
necessary. Members of the audit committee serve at the pleasure of the board,
and the board, by majority vote, may remove any member except the member of the
committee who is the certified public accountant member of the board. The
board, by majority vote, shall determine how often the audit committee shall
meet and report to the board. If the audit committee meets on the same day as
the board holds a meeting, no member shall be compensated for more than one
meeting held on that day. The audit committee shall do all of the following:

(1)
Recommend to the board an accounting firm to perform the annual
audits required under division
(B) of section 4123.47 of the Revised
Code;

(2) Recommend an
auditing firm for the board to use when conducting audits under section
4121.125 of the Revised
Code;

(3) Review the
results of each annual audit and management review and, if any problems exist,
assess the appropriate course of action to correct those problems and develop
an action plan to correct those problems;

(4)
Monitor the implementation of any action plans created pursuant to division
(A)(3) of this section;

(B)
There is hereby created the workers' compensation actuarial committee
consisting of at least three members. One member shall be the member of the
board who is an actuary. The board, by majority vote, shall appoint two
additional members of the board to serve on the actuarial committee and may
appoint additional members who are not board members, as the board determines
necessary. Members of the actuarial committee serve at the pleasure of the
board and the board, by majority vote, may remove any member except the member
of the committee who is the actuary member of the board. The board, by majority
vote, shall determine how often the actuarial committee shall meet and report
to the board. If the actuarial committee meets on the same day as the board
holds a meeting, no member shall be compensated for more than one meeting held
on that day. The actuarial committee shall do both of the following:

(1)
Recommend actuarial consultants for the board to use for the funds specified in
this chapter and Chapters 4123., 4127., and 4131. of the Revised
Code;

(2) Review
and approve the various rate schedules
prepared
and presented by the actuarial
division of the bureau or by actuarial
consultants with whom the board enters into a contract.

(1)
There is hereby created the workers' compensation investment committee
consisting of at least four members. Two of the members shall be the members of
the board who serve as the investment and securities experts on the board. The
board, by majority vote, shall appoint two additional members of the board to
serve on the investment committee and may appoint additional members who are
not board members. Each additional member the board appoints shall have at
least one of the following qualifications:

(b) Expertise
that the board determines is needed to make investment decisions.

Members of the investment
committee serve at the pleasure of the board and the board, by majority vote,
may remove any member except the members of the committee who are the
investment and securities expert members of the board. The board, by majority
vote, shall determine how often the investment committee shall meet and report
to the board. If the investment committee meets on the same day as the board
holds a meeting, no member shall be compensated for more than one meeting held
on that day.

(a)
Develop the investment policy for the administration of the investment program
for the funds specified in this chapter and Chapters 4123., 4127., and 4131. of
the Revised Code in accordance with the requirements specified in section
4123.442 of the Revised
Code;

(b) Submit the
investment policy developed pursuant to division (C)(2)(a) of this section to
the board for approval;

(c) Monitor
implementation by the administrator of workers' compensation and the bureau of
workers' compensation chief investment officer of the investment policy
approved by the board;

(d) Recommend
outside investment counsel with whom the board may contract to assist the
investment committee in fulfilling its duties;

(e)
Review the performance of the bureau of workers' compensation chief investment
officer and any investment consultants retained by the administrator to assure
that the investments of the assets of the funds specified in this chapter and
Chapters 4123., 4127., and 4131. of the Revised Code are made in accordance
with the investment policy approved by the board and to assure compliance with
the investment policy and effective management of the
funds.

(A) Investigate, ascertain, and declare and
prescribe what hours of labor, safety devices, safeguards, or other means or
methods of protection are best adapted to render the employees of every
employment and place of employment and frequenters of every place of employment
safe, and to protect their welfare as required by law or lawful orders, and
establish and maintain museums of safety and hygiene in which shall be
exhibited safety devices, safeguards, and other means and methods for the
protection of life, health, safety, and welfare of employees;

(B) Ascertain and fix reasonable standards
and prescribe, modify, and enforce reasonable orders for the adoption of safety
devices, safeguards, and other means or methods of protection to be as nearly
uniform as possible as may be necessary to carry out all laws and lawful orders
relative to the protection of the life, health, safety, and welfare of
employees in employments and places of employment or frequenters of places of
employment;

(C) Ascertain, fix,
and order reasonable standards for the construction, repair, and maintenance of
places of employment as shall render them safe;

(D) Investigate, ascertain, and determine reasonable
classifications of persons, employments, and places of employment as are
necessary to carry out the applicable sections of sections
4101.01 to
4101.16 and
4121.01 to
4121.29 of the Revised Code;

(E) Adopt reasonable and proper
rules relative to the exercise of his powers and authorities, and proper rules
to govern his proceedings and to regulate the mode and manner of all
investigations and hearings, which rules shall not be effective until ten days
after their publication; a copy of the rules shall be delivered at cost to
every citizen making application therefor;

(F) Investigate all cases of fraud or other
illegalities pertaining to the operation of the workers' compensation system
and its several insurance funds and for that purpose, the administrator has
every power of an inquisitorial nature granted to the industrial commission in
this chapter and Chapter 4123. of the Revised Code;

The bureau of workers' compensation special investigation
department is a criminal justice agency in investigating reported violations of
law relating to workers' compensation, and as such may apply for access to the
computerized databases administered by the national crime information center or
the law enforcement automated data system in Ohio and to other computerized
databases administered for the purpose of making criminal justice information
accessible to state and criminal justice agencies.

For the purpose of making any investigation with regard to any
employment or place of employment, the administrator of workers' compensation
may appoint, by an order in writing, any employee of the bureau of workers'
compensation, any deputy, who is a citizen of the state, or any other competent
person who is a resident of the state, as an agent whose duty shall be
prescribed in the order.

In the discharge of his duties the agent shall have every power
whatsoever of an inquisitorial nature granted in sections
4101.01 to
4101.16 and
4121.01 to
4121.29 of the Revised Code to the
bureau, and the same powers as a master commissioner appointed by a court of
common pleas with regard to taking testimony.

The bureau may conduct any number of investigations
contemporaneously through different agents, and may delegate to agents the
taking of all testimony bearing upon any investigation or hearing.

The decision of the bureau shall be based upon its examination
of all testimony and records. The recommendations made by agents shall be
advisory only and shall not preclude the taking of further testimony if the
bureau orders, nor further investigation.

The administrator of workers' compensation and his designees,
for the purposes mentioned in sections
4121.01 to
4121.29 of the Revised Code may
administer oaths, certify to official acts, issue subpoenas, and compel
attendance of witnesses and the production of papers, books, accounts,
documents, and testimony. In case of the failure of any person to comply with
any order of the bureau of workers' compensation or any subpoena lawfully
issued, or upon the refusal of any witness to testify to any matter regarding
which he may be lawfully interrogated, the judge of the court of common pleas
of any county in this state, on the application of the bureau, shall compel
obedience by attachment proceedings for contempt as in the case of disobedience
of the requirements of a subpoena issued from the court or a refusal to testify
therein.

Each witness who appears before the bureau of workers'
compensation by its order shall receive for the witness's attendance the fees
and mileage provided for under section
119.094 of the Revised Code, which
shall be paid from the state insurance fund on the approval of the
administrator of workers' compensation. No witnesses subpoenaed at the instance
of the parties other than the bureau is entitled to compensation from the state
for attendance or travel unless the bureau certifies that the witness's
testimony was material to the matter investigated.

(A) Upon
petition by any person that any employment or place of employment is not safe
or is injurious to the welfare of any employee or frequenter, the bureau of
workers' compensation shall proceed with or without notice to make an
investigation as is necessary to determine the matter complained of.

(B) After such hearing as is necessary, the
bureau may enter any necessary order relative thereto to render the employment
or place of employment safe and not injurious to the welfare of the employees
therein or frequenters thereof.

(C) Whenever the bureau learns that any employment or
place of employment is not safe or is injurious to the welfare of any employee
or frequenter, it may of its own motion summarily investigate the same, with or
without notice, and issue such order as is necessary thereto.

A full and complete record shall be kept of all proceedings had
before the bureau of workers' compensation on any investigation, and all
testimony shall be taken down by a stenographer appointed by the bureau.

The bureau of workers' compensation or any party may in any
investigation cause depositions of witnesses residing within or without the
state to be taken in the manner prescribed by law for like depositions in civil
actions.

Sections
4101.01 to
4101.16 and
4121.01 to
4121.29 of the Revised Code do not
deprive the legislative authority of any municipal corporation or any board of
trustees or officer of any municipal corporation of any power or jurisdiction
over or relative to any place of employment, provided that whenever the bureau
of workers' compensation, by an order, fixes a standard of safety or any
hygienic condition for employments or places of employment, the order shall,
upon the filing by the bureau of a copy thereof with the clerk of the municipal
corporation to which it applies, be held to amend or modify any similar
conflicting local order in any particular matters governed by the order.
Thereafter, no local officer shall make or enforce any order to the contrary.

Any person affected by any local order in conflict with an
order of the bureau may petition the bureau for a hearing on the ground that
the local order is unreasonable and in conflict with the order of the bureau.
The petition for hearing shall conform to the requirements set forth for a
petition in section
4121.23 of the Revised Code.

Upon receipt of the petition, the bureau shall order a hearing
to consider and determine the issues raised by the appeal, which hearing shall
be held in the municipal corporation where the local order appealed from was
made. Notice of the time and place of the hearing shall be given to the
petitioner and such other persons as the bureau finds directly interested in
the decision, including the clerk of the village or the mayor of the municipal
corporation from which the appeal came.

If upon investigation the bureau finds that the local order
appealed from is unreasonable and in conflict with the order of the bureau, the
bureau may modify its order and shall substitute for the local order appealed
from such order as is reasonable and legal in the premises, and thereafter the
local order, in such particulars, is void.

Any employer or other person interested either because of
ownership in or occupation of any property affected by any order of the bureau
of workers' compensation, or otherwise, may petition for a hearing on the
reasonableness and lawfulness of any bureau order.

The petition for hearing shall be by verified petition, filed
with the bureau, setting out specifically and in full detail the order upon
which a hearing is desired and every reason why the order is unreasonable or
unlawful, and every issue to be considered by the bureau on the hearing. The
petitioner shall be deemed to have finally waived all objection to any
irregularities and illegalities in the order upon which a hearing is sought
other than those set forth in the petition. All hearings of the bureau shall be
open to the public.

Upon receipt of the petition, if the issues raised in the
petition have theretofore been adequately considered, the bureau shall
determine the same by confirming, without hearing, its previous determination,
or if a hearing is necessary to determine the issues raised, the bureau shall
order a hearing thereon and consider and determine the matters in question at
the time prescribed.

Notice of the time and place of the hearing shall be given to
the petitioner and to such other persons as the bureau finds directly
interested in the decision.

Upon an investigation, if it is found that the order complained
of is unlawful or unreasonable, the bureau shall substitute a lawful and
reasonable order therefor.

Whenever at the time of final determination upon hearing it is
found that further time is reasonably necessary for compliance with the order
of the bureau, the bureau shall grant such time as is reasonably necessary for
compliance.

No action, proceeding, or suit to set aside, vacate, or amend
any order of the bureau of workers' compensation, or to enjoin the enforcement
thereof, shall be brought unless the plaintiff has applied to the bureau for a
hearing thereon at the time and as provided in section
4121.23 of the Revised Code and in
the petition therefor has raised every issue raised in the action.

Every order of the bureau is, in every prosecution for a
violation thereof, conclusively presumed to be just, reasonable, and lawful,
unless prior to the institution of the prosecution for the violation an action
has been brought to vacate and set aside the order as provided in section
4121.28 of the Revised Code.

Any employer or other person in interest who is dissatisfied
with any order of the bureau of workers' compensation may commence an action in
the supreme court, against the bureau as defendant, to set aside, vacate, or
amend any order on the ground that the order is unreasonable or unlawful and
the supreme court has exclusive jurisdiction to hear and determine the action.
The bureau shall be served with summons as in other civil cases.

The answer of the bureau shall be filed within ten days after
service of summons upon it and with its answer it shall file a certified
transcript of its record in the matter. Upon the filing of the answer the
action shall be at issue and shall be advanced and assigned for trial by the
court, upon the application of either party, at the earliest possible date.

If upon the trial of an action under section
4121.25 of the Revised Code it
appears that all issues arising in the action have not theretofore been
presented to the bureau of workers' compensation in the petition filed as
provided in section
4121.23 of the Revised Code, or
that the bureau has not theretofore had ample opportunity to hear and determine
any of the issues raised in the action, or has for any reason not in fact heard
and determined the issues raised, the court shall, before proceeding to render
judgment, unless the parties to the action stipulate to the contrary, transmit
to the bureau a full statement of the issues not adequately considered and
shall stay further proceedings in the action for fifteen days from the date of
transmission and may thereafter grant such further stay as is necessary.

Upon the receipt of the statement the bureau shall consider the
issues not theretofore considered, and may alter, modify, amend, or rescind its
order complained of in the action, and shall report its order thereon to the
court within ten days from the receipt of the statement from the court for
further hearing and consideration.

The court shall thereupon order such amendment or other
proceeding as is necessary to raise the issues as changed by the modification
of order as has been made by the bureau upon the hearing, if any modification
has in fact been made, and shall thereupon proceed with the action in the
manner provided by law for other civil actions.

No court of this state, except the supreme court to the extent
specified by sections
4101.01 to
4101.16 and
4121.01 to
4121.29 of the Revised Code has
jurisdiction to review, vacate, set aside, reverse, revise, correct, amend, or
annul any order of the bureau of workers' compensation, or to suspend or delay
the execution or operation thereof or to enjoin, restrain, or interfere with
the bureau in the performance of its official duties. The writ of mandamus
shall lie from the supreme court to the bureau in all proper cases.

The pendency of an action to set aside, vacate, or amend an
order of the bureau of workers' compensation shall not of itself stay or
suspend the operation of an order of the bureau, but during the pendency of the
action the supreme court may stay or suspend, in whole or in part, the
operation of the bureau's order. No order so staying or suspending an order of
the bureau shall be made by the supreme court otherwise than upon three days'
notice and after hearing.

In case the order is stayed or suspended the order of the
supreme court shall not become effective until a suspending bond has first been
executed and filed with and approved by the bureau, or by the supreme court or
the clerk thereof, payable to the state and sufficient in amount and security
to insure the prompt payment by the party petitioning to set aside, vacate, or
amend the order of all damages caused by the delay in the enforcement of the
order of the bureau.

All actions and proceedings under sections
4101.01 to
4101.16 and
4121.01 to 4121.29 of the Revised
Code and all actions or proceedings to which the bureau of workers'
compensation or the state is a party, and in which any question arises under
such sections, or under or concerning any order of the bureau, shall be
preferred over all other civil cases, except election causes and causes
involving or affecting the public utilities commission, irrespective of
position on the calendar. The same preference shall be granted upon application
of the attorney of the bureau in any action or proceeding in which he may be
allowed to intervene.

(A) All rules governing the operating procedure of the
bureau of workers' compensation and the industrial commission shall be adopted
in accordance with Chapter 119. of the Revised Code, except that determinations
of the bureau, district hearing officers, staff hearing officers, and the
commission, with respect to an individual employee's claim to participate in
the state insurance fund are governed only by Chapter 4123. of the Revised
Code.

The administrator of
workers' compensation and commission shall proceed jointly, in accordance with
Chapter 119. of the Revised Code, including a joint hearing, to adopt joint
rules governing the operating procedures of the bureau and commission.

(B) Upon submission to the bureau or the commission of
a petition containing not less than fifteen hundred signatures of adult
residents of the state, any individual may propose a rule for adoption,
amendment, or rescission by the bureau or the commission. If, upon
investigation, the bureau or commission is satisfied that the signatures upon
the petition are valid, it shall proceed, in accordance with Chapter 119. of
the Revised Code, to consider adoption, amendment, or rescission of the
rule.

(C) The administrator shall make available
electronically all rules adopted by the bureau and the commission
and shall make
available in a timely manner all rules adopted by the bureau and the commission that are
currently in force.

(D) The rule-making authority granted to the
administrator under this section does not limit the commission's rule-making
authority relative to its overall adjudicatory policy-making and management
duties under this chapter and Chapters 4123., 4127., and 4131. of the Revised
Code. The administrator shall not disregard any rule adopted by the commission,
provided that the rule is within the commission's rule-making
authority.

(A) The
administrator of workers' compensation and the industrial commission jointly
shall adopt rules covering the following general topics with respect to this
chapter and Chapter 4123. of the Revised Code:

(1) Rules that set forth any general policy
and the principal operating procedures of the bureau of workers' compensation
or commission, including but not limited to:

(a) Assignment to various operational units
of any duties placed upon the administrator or the commission by statute;

(f) Designation of
the person or persons authorized to issue directives with directives numbered
and distributed from a central distribution point to persons on a list
maintained for that purpose.

(2) A rule barring any employee of the bureau
or commission from having a workers' compensation claims file in the employee's
possession unless the file is necessary to the performance of the employee's
duties.

(3) All claims, whether of
a state fund or self-insuring employer, be processed in an orderly, uniform,
and timely fashion.

(4) Rules
governing the submission and sending of applications, notices, evidence, and
other documents by electronic means. The rules shall provide that where this
chapter or Chapter 4123., 4127., or 4131. of the Revised Code requires that a
document be in writing or requires a signature, the administrator and the
commission, to the extent of their respective jurisdictions, may approve of and
provide for the electronic submission and sending of those documents, and the
use of an electronic signature on those documents.

(A) The rules covering operating procedure and
criteria for decision-making that the administrator of workers' compensation
and the industrial commission are required to adopt pursuant to section
4121.31 of the Revised Code shall
be supplemented with operating manuals setting forth the procedural steps in
detail for performing each of the assigned tasks of each section of the bureau
of workers' compensation and commission. The administrator and commission
jointly shall adopt such manuals. No employee may deviate from manual
procedures without authorization of the section chief.

(B)
Manuals shall set forth the procedure for the assignment and transfer of claims
within sections and be designed to provide performance objectives and may
require employees to record sufficient data to reasonably measure the
efficiency of functions in all sections. The bureau shall perform periodic cost-effectiveness
analyses that shall be made available to the general assembly,
the governor, and to the public during normal working hours.

(C)
The bureau and commission jointly shall develop, adopt, and use a policy manual
setting forth the guidelines and bases for decision-making for any decision
which is the responsibility of the bureau, district hearing officers, staff
hearing officers, or the commission. Guidelines shall be set forth in the
policy manual by the bureau and commission to the extent of their respective
jurisdictions for deciding at least the following specific matters:

(8)
Determining the percentage of permanent partial disability, temporary partial
disability, temporary total disability, violations of specific safety
requirements, an award under division (B) of section
4123.57 of the Revised Code, and
permanent total disability.

(D)
The bureau shall establish, adopt, and implement policy guidelines and bases
for decisions involving reimbursement issues including, but not limited to, the
adjustment of invoices, the reduction of payments for future services when an
internal audit concludes that a health care provider was overpaid or improperly
paid for past services, reimbursement fees, or other adjustments to payments.
These policy guidelines and bases for decisions, and any changes to the
guidelines and bases, shall be set forth in a reimbursement manual and provider
bulletins.

Neither the policy
guidelines nor the bases set forth in the reimbursement manual or provider
bulletins referred to in this division is a rule as defined in section
119.01 of the Revised
Code.

(E) With respect to any determination of disability
under Chapter 4123. of the Revised Code, when the physician makes a
determination based upon statements or information furnished by the claimant or
upon subjective evidence, the physician shall clearly indicate this fact in
the
physician's report.

(F)
The administrator shall publish the manuals and make copies of all manuals
available to interested parties at cost.

(A) District
hearing officers shall hear the matters listed in division (B) of this section.
District hearing officers are in the classified civil service of the state, are
full-time employees of the industrial commission, and shall be persons admitted
to the practice of law in this state. District hearing officers shall not
engage in any other activity that interferes with their full-time employment by
the commission during normal working hours.

(B) District hearing officers shall have original
jurisdiction on all of the following matters:

(2) All appeals from a decision of
the administrator of workers' compensation under division (B) of section
4123.511 of the Revised Code;

(3) All other contested claims
matters under this chapter and Chapters 4123., 4127., and 4131. of the Revised
Code, except those matters over which staff hearing officers have original
jurisdiction.

(C) The
administrator of workers' compensation shall make available to each district
hearing officer the facilities and assistance of bureau employees and furnish
all information necessary to the performance of the district hearing officer's
duties.

(A) Staff
hearing officers shall consider and decide all matters specified in division
(B) of this section. All staff hearing officers are full-time employees of the
industrial commission and shall be admitted to the practice of law in this
state. Staff hearing officers shall not engage in any other activity that
interferes with their full-time employment by the commission during normal
working hours.

(B) Except as
provided in division (D) of this section, staff hearing officers have original
jurisdiction to hear and decide the following matters:

(1) Applications for permanent, total
disability awards pursuant to section
4123.58 of the Revised Code;

(2) Appeals from an order of a
district hearing officer issued under division (C) of section
4123.511 of the Revised Code;

(3) Applications for additional
awards for violation of a specific safety rule of the administrator of workers'
compensation pursuant to Section 35 of Article II of the Ohio Constitution;

(4) Applications for
reconsideration pursuant to division (A) of section
4123.57 of the Revised Code.
Decisions of the staff hearing officers on reconsideration pursuant to division
(A) of section
4123.57 of the Revised Code are
final.

(5) Reviews of settlement
agreements pursuant to section
4123.65 of the Revised Code.
Decisions of the staff hearing officer under that section are final and not
appealable to the commission or to court under section
4123.511 or
4123.512 of the Revised Code.

(C) The decision of a
staff hearing officer under division (D) of section
4123.511 of the Revised Code is
the decision of the commission for the purposes of section
4123.512 of the Revised Code
unless the commission hears an appeal under division (E) of section
4123.511 of the Revised Code.

(D) Staff hearing officers shall
hold hearings on all matters referred to them for hearing. Hearing procedures
shall conform to the rules the commission adopts pursuant to section
4121.36 of the Revised Code.

(A) The
industrial commission shall adopt rules as to the conduct of all hearings
before the commission and its staff and district hearing officers and the
rendering of a decision and shall focus such rules on managing, directing, and
otherwise ensuring a fair, equitable, and uniform hearing process. These rules
shall provide for at least the following steps and procedures:

(1) Adequate notice to all parties and their
representatives to ensure that no hearing is conducted unless all parties have
the opportunity to be present and to present evidence and arguments in support
of their positions or in rebuttal to the evidence or arguments of other
parties;

(4) Impartial assignment of staff and
district hearing officers and assignment of appeals from a decision of the
administrator of workers' compensation to a district hearing officer located at
the commission service office that is the closest in geographic proximity to
the claimant's residence;

(3) Signatures of each commissioner or
appropriate hearing officer on the original copy of the decision only,
verifying the commissioner's or hearing officer's vote;

(4) Description of the part of the body and
nature of the disability recognized in the claim.

(C) The commission shall adopt rules that
require the regular rotation of district hearing officers with respect to the
types of matters under consideration and that ensure that no district or staff
hearing officer or the commission hears a claim unless all interested and
affected parties have the opportunity to be present and to present evidence and
arguments in support of their positions or in rebuttal to the evidence or
arguments of other parties.

(D)
All matters which, at the request of one of the parties or on the initiative of
the administrator and any commissioner, are to be expedited, shall require at
least forty-eight hours' notice, a public hearing, and a statement in any order
of the circumstances that justified such expeditious hearings.

(E) All meetings of the commission and
district and staff hearing officers shall be public with adequate notice,
including if necessary, to the claimant, the employer, their representatives,
and the administrator. Confidentiality of medical evidence presented at a
hearing does not constitute a sufficient ground to relieve the requirement of a
public hearing, but the presentation of privileged or confidential evidence
shall not create any greater right of public inspection of evidence than
presently exists.

(F) The
commission shall compile all of its original memorandums, orders, and decisions
in a journal and make the journal available to the public with sufficient
indexing to allow orderly review of documents. The journal shall indicate the
vote of each commissioner.

(1) All original orders, rules, and
memoranda, and decisions of the commission shall contain the signatures of two
of the three commissioners and state whether adopted at a meeting of the
commission or by circulation to individual commissioners. Any facsimile or
secretarial signature, initials of commissioners, and delegated employees, and
any printed record of the "yes" and "no" vote of a commission member or of a
hearing officer on such original is invalid.

(2) Written copies of final decisions of district or
staff hearing officers or the commission that are mailed to the administrator,
employee, employer, and their respective representatives need not contain the
signatures of the hearing officer or commission members if the hearing officer
or commission members have complied with divisions (B)(3) and (G)(1) of this
section.

(1) Appoint an individual as a hearing
officer trainer who is in the unclassified civil service of the state and who
serves at the pleasure of the commission. The trainer shall be an attorney
registered to practice law in this state and have experience in training or
education, and the ability to furnish the necessary training for district and
staff hearing officers.

The hearing officer trainer shall develop and periodically
update a training manual and such other training materials and courses as will
adequately prepare district and staff hearing officers for their duties under
this chapter and Chapter 4123. of the Revised Code. All district and staff
hearing officers shall undergo the training courses developed by the hearing
officer trainer, the cost of which the commission shall pay. The commission
shall make the hearing officer manual and all revisions thereto available to
the public at cost.

The commission shall have the final right of approval over all
training manuals, courses, and other materials the hearing officer trainer
develops and updates.

(2)
Appoint a hearing administrator, who shall be in the classified civil service
of the state, for each bureau service office, and sufficient support personnel
for each hearing administrator, which support personnel shall be under the
direct supervision of the hearing administrator. The hearing administrator
shall do all of the following:

(a) Assist the
commission in ensuring that district hearing officers comply with the time
limitations for the holding of hearings and issuance of orders under section
4123.511 of the Revised Code. For
that purpose, each hearing administrator shall prepare a monthly report
identifying the status of all claims in its office and identifying specifically
the claims which have not been decided within the time limits set forth in
section 4123.511 of the Revised Code. The
commission shall submit an annual report of all such reports to the standing
committees of the house of representatives and of the state to which matters
concerning workers' compensation are normally referred.

(b) Provide information to requesting parties
or their representatives on the status of their claim;

(c) Issue compliance letters, upon a finding
of good cause and without a formal hearing in all of the following areas:

(vii) Any other matter that will cause a free
exchange of information prior to the formal hearing.

(d) Ensure that claim files are reviewed by
the district hearing officer prior to the hearing to ensure that there is
sufficient information to proceed to a hearing;

(e) Ensure that for occupational disease
claims under section
4123.68 of the Revised Code that
require a medical examination the medical examination is conducted prior to the
hearing;

(f) Take the necessary
steps to prepare a claim to proceed to a hearing where the parties agree and
advise the hearing administrator that the claim is not ready for a hearing.

(I) The
commission shall permit any person direct access to information contained in
electronic data processing equipment regarding the status of a claim in the
hearing process. The information shall indicate the number of days that the
claim has been in process, the number of days the claim has been in its current
location, and the number of days in the current point of the process within
that location.

(1) The industrial commission may establish an
alternative dispute resolution process for workers' compensation claims that
are within the commission's jurisdiction under Chapters 4121., 4123., 4127.,
and 4131. of the Revised Code when the commission determines that such a
process is necessary. Notwithstanding sections
4121.34 and
4121.35 of the Revised Code, the
commission may enter into personal service contracts with individuals who are
qualified because of their education and experience to act as facilitators in
the commission's alternative dispute resolution process.

(2) The parties' use of the alternative dispute
resolution process is voluntary, and requires the agreement of all necessary
parties. The use of the alternative dispute resolution process does not alter
the rights or obligations of the parties, nor does it delay the timelines set
forth in section
4123.511 of the Revised Code.

(3) The commission shall prepare
monthly reports and submit those reports to the governor, the president of the
senate, and the speaker of the house of representatives describing all of the
following:

(a) The names of each facilitator
employed under a personal service contract;

(b) The hourly amount of money and the total
amount of money paid to each facilitator;

(c) The number of disputed issues resolved
during that month by each facilitator;

(d) The number of decisions of each
facilitator that were appealed by a party;

(e) A certification by the commission that
the alternative dispute resolution process did not delay any hearing timelines
as set forth in section
4123.511 of the Revised Code for
any disputed issue.

(4)
The commission may adopt rules in accordance with Chapter 119. of the Revised
Code for the administration of any alternative dispute resolution process that
the commission establishes.

The administrator of
workers' compensation having, by virtue of Section 35 of Article II, Ohio
Constitution, the expenditure of the fund therein created for the investigation
and prevention of industrial accidents and diseases, shall, with the advice and
consent of the bureau of workers' compensation board of directors, in the
exercise of the administrator's authority and in the performance of the
administrator's duty, employ a superintendent and the necessary experts,
engineers, occupational safety and health
professionals, and support staff for the efficient operation of a
division of safety and hygiene of the bureau of workers' compensation, which is
hereby created.

The administrator, with
the advice and consent of the board, shall pay into the safety and hygiene
fund, which is hereby created in the state treasury, the portion of the
contributions paid by employers, calculated as though all employers paid
premiums based upon payroll, not to exceed one per cent thereof in any year, as
is necessary for the payment of the salary of the superintendent of the
division of safety and hygiene and the compensation of the other employees of
the division of safety and hygiene and for the expenses of investigations and researches
for the prevention of industrial accidents and diseases . All investment earnings of the fund shall be credited to the
fund. The administrator has the same powers to invest any of the funds
belonging to the fund as are delegated to the administrator under section
4123.44 of the Revised Code with
respect to the state insurance fund. The superintendent, under the direction of
the administrator, with the advice and consent of the board, shall conduct
investigations and researches for the prevention of industrial accidents and
diseases, conduct loss prevention programs and courses for employers, establish
and administrate cooperative programs with employers for the purchase of
individual safety equipment for employees, and print and distribute information
as may be of benefit to employers and employees. The administrator shall pay
from the safety and hygiene fund the salary of the superintendent of the
division of safety and hygiene, the compensation of the other employees of the
division of safety and hygiene, the expenses necessary or incidental to
investigations and researches for the prevention of industrial accidents and
diseases, and the cost of printing and distributing such information.

The superintendent, under
the direction of the administrator, shall prepare an annual report, addressed
to the governor, on the amount of the expenditures and the purposes for which
they have been made, and the results of the investigations and researches. The
administrator shall include the administrative costs, salaries, and other
expenses of the division of safety and hygiene as a part of the budget of the
bureau of workers' compensation that is submitted to the director of budget and
management and shall identify those expenditures separately from other bureau
expenditures.

The superintendent shall
be a competent person with at least five years' experience in industrial
accident or disease prevention work. The superintendent
shall be in the
unclassified civil service of the state.

The administrator may designate positions in the division that are in the unclassified civil service of
the state as long as the administrator determines the positions
are
primarily and distinctively administrative, managerial, or professional in
character. All other full-time employees of the division of safety and hygiene
are in the classified civil service of the state.

(1) Implement a
program of impairment evaluation training for its staff physicians;

(2) Issue a manual of commission policy as to
impairment evaluation so as to increase consistency of medical reports. This
manual shall be available to the public at cost but shall be provided free to
all physicians who treat claimants or to whom claimants are referred for
evaluation. The commission shall take steps to ensure that the manual receives
the widest possible distribution to physicians.

(3) Develop a method of peer review of
medical reports prepared by the commission referral doctors;

(4) Issue a policy manual as to the basis
upon which referrals to other than commission specialists will be made;

(5) Designate two hearing examiners
and two medical staff members who shall be specially trained in medical-legal
analysis. The specialists shall write evaluations of medical-legal problems
upon assignment by other hearing examiners or the commission. The director of
administrative services upon commission advice shall assign such employees to a
salary schedule commensurate with expertise required of them.

(6) Require that prior to any examination, a
physician to whom a claimant is referred for examination receives all necessary
medical information in the claim file about the claimant and a complete
statement as to the purpose of the examination.

(B) The commission may establish a medical section
within the commission to perform the duties assigned to the commission under
this section.

(E)
Establish a legal section within the bureau to provide legal advice and
assistance to the administrator and the administrator's staff as to claims
procedure and policy; appeals to be lodged on behalf of the state insurance
fund; and other legal issues. The bureau legal section shall act as attorney
for the state fund in administrative appeals.

(F) Establish a program for quality control, systems
design, and internal auditing. In the operation of the program, the
administrator shall ensure that audits are performed at least annually to
determine whether or not the bureau meets the performance goals the
administrator establishes.

(G)
Ensure that there exists the coordination between the central office and the
service offices necessary to facilitate open lines of communication and the
standardized procedures in conformity with the requirements set forth in the
operating manuals of the bureau. The administrator shall establish a line of
authority from the central office to the service offices of the bureau
sufficient to avoid ambiguity in the performance of any management or policy
function.

(2)
Recommend any needed improvements for changes in staff size and accessibility
to service offices;

(3) Recommend
to the administrator appropriate action concerning any allegations of
misconduct, abuse of authority, or fraud committed in his service office;

(4) Ensure that all current bureau
rules and operating procedures are carried out by all employees under his
direction;

(5) Assist claimants and
employers who contact the service office for information or assistance with
respect to claims processing and coverage.

(B) The administrator shall assign to each service
office an adequate number of investigators and field auditors.

Service directors shall make investigators available to
district hearing officers as needed.

In addition to other duties the administrator may assign to
investigators, they shall, at the service directors' direction, investigate
alleged instances of persons receiving compensation pursuant to section
4123.58 of the Revised Code and
engaging in remunerative employment that is incompatible with the terms of that
section.

(A) The administrator of workers' compensation shall
operate a program designed to inform employees and employers of their rights
and responsibilities under Chapter 4123. of the Revised Code and as part of
that program prepare and distribute pamphlets, which clearly and simply explain
at least all of the following:

(6)
The claimant's right to representation in the processing of a claim or to elect
no representation.

The administrator shall
ensure that the provisions of this section are faithfully and speedily
implemented.

(B)
The bureau of workers' compensation shall
maintain an ongoing program to identify employers subject to Chapter 4123. of
the Revised Code and to audit employers to ensure an optimum level of premium
payment. The bureau shall coordinate such efforts with other governmental
agencies which have information as to employers who are subject to Chapter
4123. of the Revised Code.

(C)
The administrator shall
handle complaints through the service offices, the claims section, and the
ombudsperson program. The administrator shall provide
toll free telephone lines for employers and claimants in order to expedite the
handling of complaints. The bureau shall monitor complaint traffic to ensure an
adequacy of telephone service to bureau offices and shall compile statistics on complaint subjects. Based
upon those compilations, the bureau shall revise procedures and rules to
correct major problem areas and submit data and recommendations annually to the
appropriate committees of the general assembly.

(A) The
administrator of workers' compensation and the industrial commission shall
cooperatively implement with adequate staff a comprehensive in-service training
program for their respective personnel that provides training with respect to
the workers' compensation system in at least all of the following areas:

(A) Adopt rules to ensure that all
compensation payments are accompanied by information which clearly indicates
the source of payment, type of payment, method of computation, inclusive days
of payment, reason for changes in payment, and telephone number or address for
inquiries;

(B) Adopt rules to
govern the method of issuing and delivering checks, including time limits for
issuance of checks;

(C) Set
standards and inform claimant of procedure for attorney or other representative
pickup of compensation payment check, and ensure that claimant has recently
executed a proper authorization to pick up the check;

(D) Prohibit any power of attorney allowing an
attorney or employee to cash or endorse a check on behalf of claimant;

(E) Implement a written procedure
for effectively obtaining notices of death of claimant and terminating
compensation payments;

(F) Adopt
rules to require that a claimant of whom medical examinations have been
requested by his employer, shall submit to such examinations and shall be
reimbursed by his employer for reasonable expenses incurred in submitting to
the examination and provide that the claimant shall be reimbursed by his
employer in an amount equal to the wages lost during the time required to
attend any such examination, in the event said claimant sustains lost wages as
a result of any such examination.

(A)
The administrator of workers' compensation shall oversee the implementation of
the Ohio workers' compensation qualified health plan system as established
under section 4121.442 of the Revised Code.

(B)
The administrator shall direct the implementation of the health partnership
program administered by the bureau as set forth in section 4121.441 of the
Revised Code. To implement the health partnership program
and to ensure the efficiency and effectiveness of the
public services provided through the program, the bureau:

(1)
Shall certify one or more external vendors, which shall be known as "managed
care organizations," to provide medical management and cost containment
services in the health partnership program for a period of two years beginning
on the date of certification, consistent with the standards established under
this section;

(2) May
recertify managed care organizations for additional periods of
two years; and

(3) May
integrate the certified managed care organizations with bureau staff and
existing bureau services for purposes of operation and training to allow the
bureau to assume operation of the health partnership program at the conclusion
of the certification periods set forth in division (B)(1) or (2) of this
section;

(4) May enter into a contract with any managed care
organization that is certified by the bureau, pursuant to division (B)(1) or
(2) of this section, to provide medical management and cost containment
services in the health partnership program.

(C)A contract entered into pursuant to division (B)(4) of
this section shall include both of the following:

(1) Incentives that may be awarded by the administrator,
at the administrator's discretion, based on compliance and performance of the
managed care organization;

(2) Penalties that may be imposed by the administrator, at
the administrator's discretion, based on the failure of the managed care
organization to reasonably comply with or perform terms of the contract, which
may include termination of the contract.

(D) Notwithstanding section 119.061 of the Revised Code, a
contract entered into pursuant to division (B)(4) of this section may include
provisions limiting, restricting, or regulating any marketing or advertising by
the managed care organization, or by any individual or entity that is
affiliated with or acting on behalf of the managed care organization, under the
health partnership program.

(E) No managed care organization shall receive
compensation under the health partnership program unless the managed care
organization has entered into a contract with the bureau pursuant to division
(B)(4) of this section.

(F)
Any managed
care organization selected shall demonstrate all of the following:

(1)
Arrangements and reimbursement agreements with a substantial number of the
medical, professional and pharmacy providers currently being utilized by
claimants.

(2) Ability
to accept a common format of medical bill data in an electronic fashion from
any provider who wishes to submit medical bill data in that form.

(3)
A computer system able to handle the volume of medical bills and willingness to
customize that system to the bureau's needs and to be operated by the
managed
care organization's staff, bureau staff, or some combination of both
staffs.

(4) A
prescription drug system where pharmacies on a statewide basis have access to
the eligibility and pricing, at a discounted rate, of all prescription
drugs.

(5) A
tracking system to record all telephone calls from claimants and providers
regarding the status of submitted medical bills so as to be able to track each
inquiry.

(6) Data
processing capacity to absorb all of the bureau's medical bill processing or at
least that part of the processing which the bureau arranges to
delegate.

(7) Capacity
to store, retrieve, array, simulate, and model in a relational mode all of the
detailed medical bill data so that analysis can be performed in a variety of
ways and so that the bureau and its governing authority can make informed
decisions.

(8) Wide
variety of software programs which translate medical terminology into standard
codes, and which reveal if a provider is manipulating the procedures codes,
commonly called "unbundling."

(9)
Necessary professional staff to conduct, at a minimum, authorizations for
treatment, medical necessity, utilization review, concurrent review,
post-utilization review, and have the attendant computer system which supports
such activity and measures the outcomes and the savings.

(10)
Management experience and flexibility to be able to react quickly to the needs
of the bureau in the case of required change in federal or state
requirements.

(1) The administrator may decertify a managed care
organization if the managed care organization does any of the following:

(a) Fails to maintain any of the requirements set forth in
division (F) of this section;

(b) Fails to reasonably comply with or to perform in
accordance with the terms of a contract entered into under division (B)(4) of
this section;

(c) Violates a rule adopted under section 4121.441 of the
Revised Code.

(2) The administrator shall provide each managed care
organization that is being decertified pursuant to division (G)(1) of this
section with written notice of the pending decertification and an opportunity
for a hearing pursuant to rules adopted by the administrator.

(1) Information contained in a
managed
care organization's application for certification in the health
partnership program, and other information furnished to the bureau by a
managed
care organization for purposes of obtaining certification or to comply
with performance and financial auditing requirements established by the
administrator, is for the exclusive use and information of the bureau in the
discharge of its official duties, and shall not be open to the public or be
used in any court in any proceeding pending therein, unless the bureau is a
party to the action or proceeding, but the information may be tabulated and
published by the bureau in statistical form for the use and information of
other state departments and the public. No employee of the bureau, except as
otherwise authorized by the administrator, shall divulge any information
secured by the employee while in the employ of the bureau in respect to a
managed
care organization's application for certification or in respect to the
business or other trade processes of any managed care
organization to any person other than the administrator or to the
employee's superior.

(2)
Notwithstanding the restrictions imposed by division (H)(1) of this
section, the governor, members of select or standing committees of the senate
or house of representatives, the auditor of state, the attorney general, or
their designees, pursuant to the authority granted in this chapter and Chapter
4123. of the Revised Code, may examine any managed care
organization application or other information furnished to the bureau by
the managed
care organization. None of those individuals shall divulge any
information secured in the exercise of that authority in respect to a
managed
care organization's application for certification or in respect to the
business or other trade processes of any managed care
organization to any person.

(I) On and after
January 1, 2001, a managed care
organization shall not be an insurance company holding a certificate of
authority issued pursuant to Title XXXIX of the Revised Code or
a health
insuring corporation holding a certificate of authority under Chapter 1751. of
the Revised Code.

(J) The
administrator may limit freedom of choice of health care provider or supplier
by requiring, beginning with the period set forth in division (B)(1) or (2) of
this section, that claimants shall pay an appropriate out-of-plan copayment for
selecting a medical provider not within the health partnership program as
provided for in this section.

(K) The
administrator, six months prior to the expiration of the bureau's certification
or recertification of the managed care organizations as
set forth in division (B)(1) or (2) of this section, may certify and provide
evidence to the governor, the speaker of the house of representatives, and the
president of the senate that the existing bureau staff is able to match or
exceed the performance and outcomes of the managed care
organizations and that the bureau should be permitted to internally
administer the health partnership program upon the expiration of the
certification or recertification as set forth in division (B)(1) or (2) of this
section.

(L) The
administrator shall establish and operate a bureau of workers' compensation
health care data program. The administrator shall develop reporting
requirements from all employees, employers , medical
providers, managed care organizations, and plans that participate
in the workers' compensation system. The administrator shall do all of the
following:

(1) Utilize
the collected data to measure and perform comparison analyses of costs,
quality, appropriateness of medical care, and effectiveness of medical care
delivered by all components of the workers' compensation system.

(2)
Compile data to support activities of the selected managed
care organizations and to measure the outcomes and savings of the health
partnership program.

(3) Publish
and report compiled data on the measures of outcomes and savings of the health
partnership program and submit the report to the president of the senate, the
speaker of the house of representatives, and the governor with the annual
report prepared under division (F)(3) of section 4121.12 of the Revised Code.
The administrator shall protect the confidentiality of all proprietary pricing
data.

(M) Any
rehabilitation facility the bureau operates is eligible for inclusion in the
Ohio workers' compensation qualified health plan system or the health
partnership program under the same terms as other providers within health care
plans or the program.

(N) In areas outside
the state or within the state where no qualified health plan or an inadequate
number of providers within the health partnership program exist, the
administrator shall permit employees to use a nonplan or nonprogram health care
provider and shall pay the provider for the services or supplies provided to or
on behalf of an employee for an injury or occupational disease that is
compensable under this chapter or Chapter 4123., 4127., or 4131. of the Revised
Code on a fee schedule the administrator adopts.

(O) No health care
provider, whether certified or not, shall charge, assess, or otherwise attempt
to collect from an employee, employer, a managed care organization, or the
bureau any amount for covered services or supplies that is in excess of the
allowed amount paid by a managed care organization, the bureau, or a qualified
health plan.

(P) The
administrator shall permit any employer or group of employers who agree to
abide by the rules adopted under this section and sections 4121.441 and
4121.442 of the Revised Code to provide services or supplies to or on behalf of
an employee for an injury or occupational disease that is compensable under
this chapter or Chapter 4123., 4127., or 4131. of the Revised Code through
qualified health plans of the Ohio workers' compensation qualified health plan
system pursuant to section 4121.442 of the Revised Code or through the health
partnership program pursuant to section 4121.441 of the Revised Code. No amount
paid under the qualified health plan system pursuant to section 4121.442 of the
Revised Code by an employer who is a state fund employer shall be charged to
the employer's experience or otherwise be used in merit-rating or determining
the risk of that employer for the purpose of the payment of premiums under this
chapter, and if the employer is a self-insuring employer, the employer shall
not include that amount in the paid compensation the employer reports under
section 4123.35 of the Revised Code.

(A)
The administrator of workers' compensation, with the advice and consent of the
bureau of workers' compensation board of directors, shall adopt rules under
Chapter 119. of the Revised Code for the health care partnership program
administered by the bureau of workers' compensation to provide medical,
surgical, nursing, drug, hospital, and rehabilitation services and supplies to
an employee for an injury or occupational disease that is compensable under
this chapter or Chapter 4123., 4127., or 4131. of the Revised Code, and to regulate contracts with managed care organizations
pursuant to this chapter.

(a) Procedures for
the resolution of medical disputes between an employer and an employee, an
employee and a provider, or an employer and a provider, prior to an appeal
under section 4123.511 of the Revised Code. Rules the administrator adopts
pursuant to division (A)(1)(a) of this section
may specify that the resolution procedures shall not be used to resolve
disputes concerning medical services rendered that have been approved through
standard treatment guidelines, pathways, or presumptive authorization
guidelines.

(b) Prohibitions
against discrimination against any category of health care providers;

(c) Procedures for
reporting injuries to employers and the bureau by providers;

(d) Appropriate
financial incentives to reduce service cost and insure proper system
utilization without sacrificing the quality of service;

(f) A timely and
accurate method of collection of necessary information regarding medical and
health care service and supply costs, quality, and utilization to enable the
administrator to determine the effectiveness of the program;

(g) Provisions for
necessary emergency medical treatment for an injury or occupational disease
provided by a health care provider who is not part of the program;

(h) Discounted
pricing for all in-patient and out-patient medical services, all professional
services, and all pharmaceutical services;

(k) Standards and
criteria for the bureau to utilize in certifying or recertifying a health care
provider or a managed care organization for participation in the
health partnership program;

(l) Standards
for the bureau to utilize in
penalizing or decertifying a health care provider from participation in the health
partnership program.

(2) Notwithstanding section 119.061 of the Revised Code, the
rules may include provisions limiting, restricting, or regulating any marketing
or advertising by a managed care organization, or by any individual or entity
that is affiliated with or acting on behalf of the managed care organization,
under the health partnership program.

(B)
The administrator shall implement the health partnership program according to
the rules the administrator adopts under this section for the provision and
payment of medical, surgical, nursing, drug, hospital, and rehabilitation
services and supplies to an employee for an injury or occupational disease that
is compensable under this chapter or Chapter 4123., 4127., or 4131. of the
Revised Code."

(A) The
administrator of workers' compensation shall develop standards for
qualification of health care plans of the Ohio workers' compensation qualified
health plan system to provide medical, surgical, nursing, drug, hospital, and
rehabilitation services and supplies to an employee for an injury or
occupational disease that is compensable under this chapter or Chapter 4123.,
4127., or 4131. of the Revised Code. In adopting the standards, the
administrator shall use nationally recognized accreditation standards. The
standards the administrator adopts must provide that a qualified plan provides
for all of the following:

(3) Procedures for the
resolution of medical disputes between an employee and an employer, an employee
and a provider, or an employer and a provider, prior to an appeal under section
4123.511 of the Revised Code;

(4) Authorize employees who are
dissatisfied with the health care services of the employer's qualified plan and
do not wish to obtain treatment under the provisions of this section, to
request the administrator for referral to a health care provider in the
bureau's health care partnership program. The administrator must refer all
requesting employees into the health care partnership program.

(5) Does not discriminate against any
category of health care provider;

(6) Provide a procedure for reporting
injuries to the bureau of workers' compensation and to employers by providers
within the qualified plan;

(7)
Provide appropriate financial incentives to reduce service costs and
utilization without sacrificing the quality of service;

(9) Provide a timely and
accurate method of reporting to the administrator necessary information
regarding medical and health care service and supply costs, quality, and
utilization to enable the administrator to determine the effectiveness of the
plan;

(10) Authorize necessary
emergency medical treatment for an injury or occupational disease provided by a
health care provider who is not a part of the qualified health care plan;

(11) Provide an employee the right
to change health care providers within the qualified health care plan;

(13)
Authorize necessary medical treatment for employees who work in Ohio but reside
in another state.

(B)
Health care plans that meet the approved qualified health plan standards shall
be considered qualified plans and are eligible to become part of the Ohio
workers' compensation qualified health plan system. Any employer or group of
employers may provide medical, surgical, nursing, drug, hospital, and
rehabilitation services and supplies to an employee for an injury or
occupational disease that is compensable under this chapter or Chapter 4123.,
4127., or 4131. of the Revised Code through a qualified health plan.

(A) The bureau of workers'
compensation may summarily suspend the certification of a provider to
participate in the health partnership program created under sections 4121.44
and 4121.441 of the Revised Code without a prior hearing if the bureau
determines any of the following apply to the provider:

(1) The professional license, certification, or
registration held by the provider to practice the provider's profession has
been revoked or suspended for an indefinite period of time or for a period of
more than thirty days, subsequent to the provider's certification to
participate in the health partnership program.

(2) The provider has been convicted of or has pleaded
guilty to a violation of section 2913.48 or sections 2923.31 to 2923.36 of the
Revised Code or has been convicted of or pleaded guilty to any other criminal
offense related to the delivery of or billing for health care services.

(3) The bureau determines, by
clear and convincing evidence, that the continued participation by the provider
in the health partnership program presents a danger of immediate and serious
harm to claimants.

(B) The bureau shall issue a written order of summary
suspension by certified mail or in person in accordance with section 119.07 of
the Revised Code. If the provider subject to the summary suspension requests an
adjudicatory hearing by the bureau, the date set for the hearing shall be not
later than fifteen days, but not earlier than seven days, after the provider
requests the hearing, unless otherwise agreed to by both the bureau and the
provider.

(C) If an order issued
pursuant to this section is appealed, the court may stay execution of the order
and fix the terms of the stay, if the court finds both of the following:

(1) That an unusual hardship to the appellant will result
from execution of the order pending appeal;

(2) That the health, safety, and welfare of the public
will not be threatened by staying execution of the order pending appeal.

(D) A court or agency order
staying the suspension of a professional license, certification, or
registration shall not affect the ability of the bureau to suspend the
certification of a provider to participate in the health partnership program
under this section.

(E) The summary suspension of a certification of a
provider under this section shall not affect the ability of that provider to
receive payment for services rendered prior to the effective date of the
suspension.

(F) Any summary suspension
imposed under this section shall remain in effect, unless reversed on appeal,
until a final adjudication order issued by the bureau pursuant to this section
and Chapter 119. of the Revised Code takes effect. The bureau shall issue its
final adjudication order within seventy-five days after completion of its
hearing. A failure to issue the order within the seventy-five-day time period
shall result in dissolution of the summary suspension order but shall not
invalidate any subsequent, final adjudication order.

(A) No
person, health care provider, managed care organization, or owner of a health
care provider or managed care organization shall obtain or attempt to obtain
payments by deception under Chapter 4121., 4123., 4127., or 4131. of the
Revised Code to which the person, health care provider, managed care
organization, or owner is not entitled under rules of the bureau of workers'
compensation adopted pursuant to sections
4121.441 and
4121.442 of the Revised Code.

(B) Any person, health care
provider, managed care organization, or owner that violates division (A) of
this section is liable, in addition to any other penalties provided by law, for
all of the following penalties:

(1) Payment
of interest on the amount of the excess payments at the maximum interest rate
allowable for real estate mortgages under section
1343.01 of the Revised Code. The
interest shall be calculated from the date the payment was made to the person,
owner, health care provider, or managed care organization through the date upon
which repayment is made to the bureau or the self-insuring employer.

(2) Payment of an amount equal to three times
the amount of any excess payments;

(3) Payment of a sum of not less than five
thousand dollars and not more than ten thousand dollars for each act of
deception;

(4) All reasonable and
necessary expenses that the court determines have been incurred by the bureau
or the self-insuring employer in the enforcement of this section.

All moneys collected by the bureau pursuant to this section
shall be deposited into the state insurance fund created in section
4123.30 of the Revised Code. All
moneys collected by a self-insuring employer pursuant to this section shall be
awarded to the self-insuring employer.

(1) In addition
to the monetary penalties provided in division (B) of this section and except
as provided in division (C)(3) of this section, the administrator may terminate
any agreement between the bureau and a person or a health care provider or
managed care organization or its owner and cease reimbursement to that person,
provider, organization, or owner for services rendered if any of the following
apply:

(a) The person, health care provider,
managed care organization, or its owner, or an officer, authorized agent,
associate, manager, or employee of a person, provider, or organization is
convicted of or pleads guilty to a violation of sections
2913.48 or
2923.31 to
2923.36 of the Revised Code or any
other criminal offense related to the delivery of or billing for health care
benefits.

(b) There exists an entry
of judgment against the person, health care provider, managed care
organization, or its owner, or an officer, authorized agent, associate,
manager, or employee of a person, provider, or organization and proof of the
specific intent of the person, health care provider, managed care organization,
or owner to defraud, in a civil action brought pursuant to this section.

(c) There exists an entry of
judgment against the person, health care provider, managed care organization,
or its owner, or an officer, authorized agent, associate, manager, or employee
of a person, provider, or organization in a civil action brought pursuant to
sections 2923.31 to
2923.36 of the Revised Code.

(2) No person, health
care provider, or managed care organization that has had its agreement with and
reimbursement from the bureau terminated by the administrator pursuant to
division (C)(1) of this section, or an owner, officer, authorized agent,
associate, manager, or employee of that person, health care provider, or
managed care organization shall do either of the following:

(a) Directly provide services to any other
bureau provider or have an ownership interest in a provider of services that
furnishes services to any other bureau provider;

(b) Arrange for, render, or order services
for claimants during the period that the agreement of the person, health care
provider, managed care organization, or its owner is terminated as described in
division (C)(1) of this section;

(3) The administrator shall not terminate the
agreement or reimbursement if the person, health care provider, managed care
organization, or owner demonstrates that the person, provider, organization, or
owner did not directly or indirectly sanction the action of the authorized
agent, associate, manager, or employee that resulted in the conviction, plea of
guilty, or entry of judgment as described in division (C)(1) of this section.

(4) Nothing in division (C) of
this section prohibits an owner, officer, authorized agent, associate, manager,
or employee of a person, health care provider, or managed care organization
from entering into an agreement with the bureau if the provider, organization,
owner, officer, authorized agent, associate, manager, or employee demonstrates
absence of knowledge of the action of the person, health care provider, or
managed care organization with which that individual or organization was
formerly associated that resulted in a conviction, plea of guilty, or entry of
judgment as described in division (C)(1) of this section.

(D) The attorney general may bring an action
on behalf of the state and a self-insuring employer may bring an action on its
own behalf to enforce this section in any court of competent jurisdiction. The
attorney general may settle or compromise any action brought under this section
with the approval of the administrator.

Notwithstanding any other law providing a shorter period of
limitations, the attorney general or a self-insuring employer may bring an
action to enforce this section at any time within six years after the conduct
in violation of this section terminates.

(E) The availability of remedies under this section
and sections
2913.48 and
2923.31 to
2923.36 of the Revised Code for
recovering benefits paid on behalf of claimants for medical assistance does not
limit the authority of the bureau or a self-insuring employer to recover excess
payments made to an owner, health care provider, managed care organization, or
person under state and federal law.

The department of administrative services shall select one or
more managed care organizations for each state office, agency, institution,
board, or commission, except for a public college or university, unless
otherwise agreed to between the department and a state office, agency,
institution, board, or commission.

Each contract the administrator of workers' compensation enters into with a
managed care organization under division (B)(4) of section 4121.44 of the
Revised Code shall require the managed care organization to enter into a data
security agreement with the state board of pharmacy governing the managed care
organization's use of the board's drug database established and maintained
under section 4729.75 of the Revised Code.

This section does not apply if the board no longer
maintains the drug database.

(A) There is hereby created a workers' compensation
ombudsperson system to assist claimants and employers in matters dealing with
the bureau of workers' compensation and the industrial commission. The
industrial commission nominating council shall appoint a chief ombudsperson.
The chief ombudsperson, with the advice and consent of the
nominating council, may appoint such assistant
ombudspersons as the nominating council deems necessary. The
position of chief ombudsperson
is for a term of six years. A person appointed to the
position of chief ombudsperson shall serve at the pleasure of
the nominating council. The chief ombudsperson may not be transferred,
demoted, or suspended during the person's tenure and may be removed by the
nominating council only upon a vote of not fewer than nine members of the nominating
council. The chief ombudsperson shall devote
the chief
ombudsperson's full time and attention to the duties of
the
ombudsperson's office. The administrator of workers' compensation shall
furnish the chief
ombudsperson with the office space, supplies, and clerical assistance
that will enable the chief ombudsperson and the ombudsperson system staff
to perform their duties effectively. The ombudsperson program shall be funded
out of the budget of the bureau and the chief ombudsperson and
the ombudsperson system staff shall be carried on the
bureau payroll . The chief ombudsperson and the ombudsperson system
shall be under the direction of the nominating council. The administrator and
all employees of the bureau and the commission shall give the
the
ombudsperson system staff full and prompt cooperation in all matters
relating to the duties of the chief
ombudsperson.

(1) Answer
inquiries or investigate complaints made by employers or claimants under this
chapter and Chapter 4123. of the Revised Code as they relate to the processing
of a claim for workers' compensation benefits;

(2)
Provide claimants and employers with information regarding problems which arise
out of the functions of the bureau, commission hearing officers, and the
commission and the procedures employed in the processing of claims;

(3)
Answer inquiries or investigate complaints of an employer as they relate to
reserves established and premiums charged in connection with the employer's
account;

(4) Comply with Chapter 102. and sections 2921.42 and 2921.43
of the Revised Code and the nominating council's human resource and ethics
policies;

(5) Not express any opinions as to the merit of a claim or the
correctness of a decision by the various officers or agencies as the decision
relates to a claim for benefits or compensation.

For the purpose of
carrying out the chief ombudsperson's duties, the chief ombudsperson or the
ombudsperson system staff, notwithstanding sections
4123.27 and 4123.88 of the Revised Code, has the right at all reasonable times
to examine the contents of a claim file and discuss with parties in interest
the contents of the file as long as the ombudsperson does not divulge
information that would tend to prejudice the case of either party to a claim or
that would tend to compromise a privileged attorney-client or doctor-patient
relationship.

(1) Assist any
service office in its duties whenever it requires assistance or information
that can best be obtained from central office personnel or records;

(2)
Annually assemble reports from each assistant ombudsperson as to their
activities for the preceding year together with their recommendations as to
changes or improvements in the operations of the workers' compensation system.
The chief ombudsperson shall prepare a written report summarizing the
activities of the ombudsperson system together with a digest of
recommendations. The chief ombudsperson shall transmit the report to the
nominating council.

(3) Comply with Chapter 102. and sections 2921.42 and 2921.43
of the Revised Code and the nominating council's human resource and ethics
policies.

(1)
Represent a claimant or employer in claims pending before or to be filed with
the administrator, a district or staff hearing officer, the commission, or the
courts of the state, nor shall an ombudsperson or assistant ombudsperson
undertake any such representation for a period of one year after the
ombudsperson's or assistant ombudsperson's employment terminates or be eligible
for employment by the bureau or the commission or as a district or staff
hearing officer for one year;

(2)
Express any opinions as to the merit of a claim or the correctness of a
decision by the various officers or agencies as the decision relates to a claim
for benefits or compensation.

(E)
The chief ombudsperson and assistant ombudspersons shall receive compensation
at a level established by the nominating council commensurate with the
individual's background, education, and experience in workers' compensation or
related fields. The chief ombudsperson and assistant ombudspersons are
full-time permanent employees in the unclassified service of the state
and are entitled to all benefits that accrue to such employees, including,
without limitation, sick, vacation, and personal leaves.
Assistant ombudspersons serve at the pleasure of the
chief ombudsperson.

(F) In the event of a vacancy in the position of chief
ombudsperson, the nominating council may appoint a person to serve as acting
chief ombudsperson until a chief ombudsperson is appointed. The acting chief
ombudsperson shall be under the direction and control of the nominating council
and may be removed by the nominating council with or without just cause.

(A) No
employer shall violate a specific safety rule adopted by the administrator of
workers' compensation pursuant to section
4121.13 of the Revised Code or an
act of the general assembly to protect the lives, health, and safety of
employees pursuant to section 35 of Article II, Ohio Constitution. Chapter
4167. of the Revised Code and rules and standards adopted thereunder are not
the rules or enactment referred to in this division and shall not be considered
as such for purposes of this section.

(B) If a staff hearing officer, in the course of the
staff hearing officer's determination of a claim for an additional award under
Section 35 of Article II, Ohio Constitution, finds the employer guilty of
violating division (A) of this section, the staff hearing officer shall, in
addition to any award paid to the claimant, issue an order to the employer to
correct the violation within the period of time the staff hearing officer
fixes. For any violation occurring within twenty-four months of the last
violation, the staff hearing officer shall assess against the employer a civil
penalty in an amount the staff hearing officer determines up to a maximum of
fifty thousand dollars for each violation. In fixing the exact penalty, the
staff hearing officer shall base the decision upon the size of the employer as
measured by the number of employees, assets, and earnings of the employer.

(C) An employer dissatisfied with
the imposition of a civil penalty pursuant to division (B) of this section may
appeal the staff hearing officer's decision, if the commission refuses to hear
the appeal under division (E) of section
4123.511 of the Revised Code, or a
decision of the commission, if the commission hears the appeal under that
division, to a court of common pleas pursuant to the Rules of Civil Procedure.
An appeal operates to stay the payment of the fine pending the appeal.

(D) The administrator shall
deposit all penalties collected pursuant to this section in the safety and
hygiene fund established pursuant to section
4121.37 of the Revised Code.

Not later than July
1, 2012, the administrator of workers' compensation shall adopt rules in
accordance with Chapter 119. of the Revised Code to implement a coordinated
services program for claimants under this chapter or Chapter 4123., 4127., or
4131. of the Revised Code who are found to have obtained prescription drugs
that were reimbursed pursuant to an order of the administrator or of the
industrial commission or by a self-insuring employer but were obtained at a
frequency or in an amount that is not medically necessary. The program shall be
implemented in a manner that is substantially similar to the coordinated
services programs established for the medicaid program under
sections 5164.758 and 5167.13 of
the Revised Code.

(A) As used in sections
4121.61 to
4121.69 of the Revised
Code, "self-insuring employer" has the same meaning as in section
4123.01 of the Revised
Code.

(B) The administrator of workers' compensation, with
the advice and consent of the bureau of workers' compensation board of
directors, shall adopt rules, take measures, and make expenditures as it deems
necessary to aid claimants who have sustained compensable injuries or incurred
compensable occupational diseases pursuant to Chapter 4123., 4127., or 4131. of
the Revised Code to return to work or to assist in lessening or removing any
resulting handicap.

(B) Nothing in
sections 4121.61 to
4121.69 of the Revised Code shall
be interpreted to grant authority to the administrator to require a claimant to
utilize a public provider of rehabilitation services, counseling, or training.

Claimants who the administrator of workers' compensation
determines could probably be rehabilitated to achieve the goals established by
section 4121.61 of the Revised Code and
who agree to undergo rehabilitation shall be paid living maintenance payments
for a period or periods which do not exceed six months in the aggregate, unless
review by the administrator or the administrator's designee reveals that the
claimant will be benefited by an extension of such payments.

Living maintenance payments shall be paid in weekly amounts,
not to exceed the amount the claimant would receive if the claimant were being
compensated for temporary total disability, but not less than fifty per cent of
the current state average weekly wage. Living maintenance payments shall
commence at the time the claimant begins to participate in an approved
rehabilitation program.

A claimant receiving living maintenance payments shall be
deemed to be temporarily totally disabled and shall receive no payment of any
type of compensation except as provided by division (B) of section
4123.57 of the Revised Code for
the periods during which the claimant is receiving living maintenance payments.

(A)Except as provided in division (D) of this section,
the administrator of workers' compensation shall pay the expense of
providing rehabilitation services, counseling, training, and living maintenance
payments from the surplus fund established by section
4123.34 of the Revised
Code.

(B) Living maintenance payments are not subject to
garnishment, levy, or attachment.

(A) The administrator of workers' compensation, with
the advice and consent of the bureau of workers' compensation board of
directors, shall adopt rules:

(1) For the
encouragement of reemployment of claimants who have successfully completed
prescribed rehabilitation programs by payment from the surplus fund established
by section 4123.34 of the Revised Code to
employers who employ or re-employ the claimants. The period or periods of
payments shall not exceed six months in the aggregate, unless the administrator
or the administrator's designee determines that the claimant will be benefited
by an extension of payments.

(2) Requiring
payment, in the same manner as living maintenance payments are made pursuant to
section 4121.63 of the Revised Code, to
the claimant who completes a rehabilitation training program and returns to
employment, but who suffers a wage loss compared to the wage the claimant was
receiving at the time of injury. Payments per week shall be sixty-six and
two-thirds per cent of the difference, if any, between the claimant's weekly
wage at the time of injury and the weekly wage received while employed, up to a
maximum payment per week equal to the statewide average weekly wage. The
payments may continue for up to a maximum of two hundred weeks but shall be
reduced by the corresponding number of weeks in which the claimant receives
payments pursuant to division (B) of section
4123.56 of the Revised
Code.

(B) A self-insuring employer
shall make the payments described in division (A) of this section directly as
part of a claim.

In the event a claimant
sustains an injury or occupational disease or dies as a result of any injury or
disease received in the course of and arising out of the claimant's
participation in a rehabilitation program, the claimant or, in the case of
death, a dependent of the claimant, may file a claim for compensation and
benefits. All compensation and benefit awards made as a result of the injury,
disease, or death shall be charged to the surplus fund account, created
pursuant to section 4123.34 of the Revised Code, and
not charged through the state insurance fund to the employer against which the
claim was allowed so long as the employer pays assessments into the surplus
fund account for the payment of such compensation and benefits.
If an employer is a self-insuring employer, the
self-insuring employer shall pay these compensation and benefits directly as a
part of a claim.

(A)
The administrator of workers' compensation may establish compensation plans,
including schedules of hourly rates, for the compensation of professional,
administrative, and managerial employees who are employed to fulfill the duties
placed upon the bureau of workers' compensation pursuant to sections 4121.61 to
4121.69 of the Revised Code. The administrator may establish rules or policies
for the administration of the respective compensation plans.

This division does not
apply to employees for whom the state employment relations board establishes
appropriate bargaining units pursuant to section 4117.06 of the Revised
Code.

(B) The administrator may employ the services and
resources of any public entity or private person, business, or association in
fulfilling the duties placed upon the bureau of workers' compensation by
sections 4121.61 to 4121.69 of the Revised Code. The opportunities for Ohioans with disabilities agency,
the director of job and family services, and any other public officer,
employee, or agency shall give to the bureau of workers' compensation full
cooperation and, at the request of the administrator, enter into a written
agreement stating the procedures and criteria for referring, accepting, and
providing services to claimants in the job placement and rehabilitation efforts
of the bureau of workers' compensation on behalf of a claimant when referred by
the bureau of workers' compensation.

(C)
In appropriate cases, the bureau may refer a candidate to the
opportunities for Ohioans with disabilities agency for
participation in a program of the agency.
For that purpose, the bureau of workers' compensation shall compensate the
agency for the nonfederal portion of its
services.